Follow-up studies in patients with right bundle branch block and left anterior hemiblock: significance of H-V interval.
Thirty-eight patients with right bundle branch block and left anterior hemiblock who had undergone His bundle recordings were prospectively followed for development of heart block. Twenty-five were male and thirteen female. Their ages ranged from 35 to 92 with an average age of 74 years. The mean follow-up period was 28.5 months (range 2-52 months). The H-V interval was 55 msec or less in 17 patients (Group A), between 56 and 75 msec in 13 (Group B), and more than 75 msec in eight (Group C). Ten patients (26%) died during the follow-up period. Of these, three were in Group A (mortality rate 8% per year), three in Group B 10% per year), and four in Group C (21% per year). None of the deaths in Groups A and B were sudden, while one possible sudden death occurred in Group C. Mode of death in one patient each from Groups B and C remained unknown. Heart block was not seen in any patient from Group A and B, while two patients from Group C progressed to complete heart block during the follow-up period. It is concluded that patients with right bundle branch block and left anterior hemiblock with prolonged H-V intervals tend to show a higher mortality when compared to those with normal H-V intervals. A definite risk of heart block exists in patients with H-V intervals of more than 75 msec.
D000328:Adult; D000368:Aged; D002036:Bundle of His / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D013997:Time Factors