PMID- 16789976
OWN - NLM
STAT- MEDLINE
DCOM- 20060731
LR  - 20071115
IS  - 0954-6820 (Print)
IS  - 0954-6820 (Linking)
VI  - 260
IP  - 1
DP  - 2006 Jul
TI  - Long-term prognosis in patients with bifascicular block--the predictive value of 
      noninvasive and invasive assessment.
PG  - 31-8
AB  - OBJECTIVES: Patients with bifascicular block (BFB) have a high mortality rate. 
      The purpose of the present study was to identify high-risk patients in a BFB 
      population by performing an extensive cardiac evaluation including noninvasive 
      and invasive tests. DESIGN: Population-based study. SUBJECTS: A total of 100 
      patients with BFB, of whom 41 had a history of unexplained syncope, were 
      prospectively studied. The mean age was 68 +/- 12. All patients were investigated 
      with Holter-monitoring, an exercise test, an echocardiography, and an invasive 
      electrophysiological study. The severity of congestive heart failure (CHF) was 
      assessed by New York Heart Association (NYHA) classification. Patients in NYHA 
      class IV were excluded. INTERVENTIONS: Patients with syncope were recommended 
      prophylactic pacemaker treatment, which was accepted by 31 patients (76%). Main 
      outcome measures. All-cause mortality and sudden cardiac death (SCD). RESULTS: 
      During a median follow-up of 84 months, 33 patients died, of whom 14 in SCD. In a 
      univariate analysis, high age, a previous myocardial infarction, and CHF were 
      associated with a significantly increased risk of all-cause mortality and SCD. In 
      a Cox multiple regression analysis, CHF was the only independent predictor of 
      all-cause mortality and SCD (P < 0.01). CONCLUSION: Patients with BFB have a poor 
      long-term prognosis. The predictive value of noninvasive and invasive 
      investigations is limited. The only independent predictor of all-cause mortality 
      and SCD in this population was the presence of CHF.
FAU - Tabrizi, F
AU  - Tabrizi F
AD  - Department of Cardiology, Karolinska Institute, South Hospital, Stockholm, 
      Sweden. fariborz.tabrizi@sodersjukhuset.se
FAU - Rosenqvist, M
AU  - Rosenqvist M
FAU - Bergfeldt, L
AU  - Bergfeldt L
FAU - Englund, A
AU  - Englund A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Bundle-Branch Block/*diagnosis/physiopathology/therapy
MH  - Cardiac Pacing, Artificial
MH  - Chronic Disease
MH  - Death, Sudden, Cardiac/etiology
MH  - Electrocardiography, Ambulatory
MH  - Epidemiologic Methods
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Syncope/etiology/therapy
EDAT- 2006/06/23 09:00
MHDA- 2006/08/01 09:00
CRDT- 2006/06/23 09:00
PHST- 2006/06/23 09:00 [pubmed]
PHST- 2006/08/01 09:00 [medline]
PHST- 2006/06/23 09:00 [entrez]
AID - JIM1651 [pii]
AID - 10.1111/j.1365-2796.2006.01651.x [doi]
PST - ppublish
SO  - J Intern Med. 2006 Jul;260(1):31-8. doi: 10.1111/j.1365-2796.2006.01651.x.