European Heart Journal Advance Access originally published online on October 7, 2005
European Heart Journal 2005 26(21):2300-2306; doi:10.1093/eurheartj/ehi580
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Bundle-branch block in middle-aged men: risk of complications and death over 28 years
The Primary Prevention Study in Göteborg, Sweden
1Clinical Experimental Research Lab, The Cardiovascular Institute, Göteborg University, Drakeg 6, SE-41250 Göteborg, Sweden
2Preventive Cardiology, The Cardiovascular Institute, Göteborg University, Drakeg 6, SE-41250 Göteborg, Sweden
3Department of Medicine, Sahlgrenska University Hospital/Östra Sjukhuset, Göteborg, Sweden
Received 7 January 2005; revised 23 August 2005; accepted 15 September 2005; online publish-ahead-of-print 7 October 2005.
* Corresponding author. Tel: +46 31 3434100.E-mail address: peter.eriksson{at}vgregion.se
See page 2222 for the editorial comment on this article (doi:10.1093/eurheartj/ehi390)
Aims To investigate the long-term fate of men with bundle-branch block (BBB) from a general population sample.
Methods and results Data were derived from 7392 men without a history of myocardial infarction or stroke, born between 1915 and 1925 and investigated between 1970 and 1973. All participants were followed from the date of their baseline examination until 1998. We identified 70 men with right-BBB and 46 men with left-BBB at baseline. In men with right-BBB, there was no increased risk of myocardial infarction, coronary death, heart failure, or all-cause mortality during follow-up. The multiple-adjusted hazard ratio for progression to high-degree atrioventricular block was 3.64 (99% confidence interval 0.79–16.72). In men with left-BBB, the hazard ratio for high-degree atrioventricular block was 12.89 (4.13–40.24). However, hazard ratio for all-cause mortality was 1.85 (1.15–2.97) when compared with men without BBB, mostly due to outside hospital coronary deaths, whose hazard ratio was 4.22 (1.90–9.34).
Conclusion The presence of BBB was strongly associated with future high-degree atrioventricular block that was more pronounced for left-BBB. Men with left-BBB have a substantially increased risk of coronary death, mainly due to sudden death outside the hospital setting.
Key Words: Bundle-branch block • Ischaemic heart disease • High-degree atrioventricular block • Prognosis • Sudden death
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