Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Clinical implications of electrocardiographic bundle branch block in primary care

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Prevalence of heart failure and other risk factors among first-degree relatives of women with peripartum cardiomyopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Different defibrillation strategies in survivors after out-of-hospital cardiac arrest

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Syncope and orthostatic hypotension: early markers of cardiac disease in the general population

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Heritability of resting heart rate and association with mortality in middle-aged and elderly twins

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Polygenic predisposition to breast cancer and the risk of coronary artery disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Cardiovascular Manifestations of Systemic Sclerosis: A Danish Nationwide Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Association of Carpal Tunnel Syndrome With Amyloidosis, Heart Failure, and Adverse Cardiovascular Outcomes

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVES: Electrocardiographic bundle branch block (BBB) is common but the prognostic implications in primary care are unclear. We sought to investigate the relationship between electrocardiographic BBB subtypes and the risk of cardiovascular (CV) outcomes in a primary care population free of major CV disease.

METHODS: Retrospective cohort study of primary care patients referred for electrocardiogram (ECG) recording between 2001 and 2011. Cox regression models were used to estimate hazard ratios (HR) as well as absolute risks of CV outcomes based on various BBB subtypes.

RESULTS: We included 202 268 individuals with a median follow-up period of 7.8 years (Inter-quartile range [IQR] 4.9-10.6). Left bundle branch block (LBBB) was associated with heart failure (HF) in both men (HR 3.96, 95% CI 3.30 to 4.76) and women (HR 2.51, 95% CI 2.15 to 2.94) and with CV death in men (HR 1.80, 95% CI 1.38 to 2.35). Right bundle branch block (RBBB) was associated with pacemaker implantation in both men (HR 3.26, 95% CI 2.74 to 3.89) and women (HR 3.69, 95% CI 2.91 to 4.67), HF in both sexes and weakly associated with CV death in men. Regarding LBBB, we found an increasing hazard of HF with increasing QRS-interval duration (HR 1.25, 95% CI 1.11 to 1.42 per 10 ms increase in men and HR 1.23, 95% CI 1.08 to 1.40 per 10 ms increase in women). Absolute 10-year risk predictions across age-specific and sex-specific subgroups revealed clinically relevant differences between having various BBB subtypes.

CONCLUSIONS: Opportunistic findings of BBB subtypes in primary care patients without major CV disease should be considered warnings of future HF and pacemaker implantation.

Original languageEnglish
JournalHeart (British Cardiac Society)
Volume105
Issue number15
Pages (from-to)1160-1167
Number of pages8
ISSN1355-6037
DOIs
Publication statusPublished - Aug 2019

ID: 57661204