Long-term survival of patients with incomplete bundle-branch block complicating acute myocardial infarction.

Abstract

Bundle-branch block complicating acute myocardial infarction is associated with an increased mortality (Godman, Lassers, and Julian, I970; Atkins et al., 1973). This increased mortality is related to both a greater amount of myocardial damage and a greater risk of complete heart block and asystole (Fenig and Lichstein, 1972).Various forms of incomplete bilateral bundlebranch block have been recognized as precursors of complete heart block (Scanlon, Pryor, and Blount, I970). These include right bundle-branch block with left anterior hemiblock, right bundle-branch block with left posterior hemiblock, alternating right bundle-branch block and left bundle-branch block in the same or serial tracings, and first degree atrioventricular block with bundle-branch block and an unusually prolonged QRS. Though some reservations exist (Godman et al., I970; Scheinman and Brenman, I972), immediate insertion of a