title: The Prognostic Significance of Right Bundle Branch Block: A Meta-analysis of Prospective Cohort Studies.
abstract: BACKGROUND
  The prognostic significance of right bundle branch block (RBBB) is inconsistent across studies. We aimed to assess the association between RBBB (in general population and patients with heart disease) and risk of all-cause mortality, cardiac death, acute myocardial infarction (MI), and heart failure (HF).
  
  
  OBJECTIVE
  RBBB may be associated with increased risk of death.
  
  
  METHODS
  PubMed, EMBASE, and the Cochrane Library up to February 2015 were searched for prospective cohort studies that reported RBBB at baseline and all-cause mortality, cardiac death, MI, and HF at follow-up. A meta-analysis of published data was undertaken primarily by means of fixed-effects models.
  
  
  RESULTS
  Nineteen cohort studies including 201 437 participants were included with a mean follow-up period ranging from 1 to 246 months. For general population with RBBB, the pooled adjusted hazard ratio (HR) for all-cause mortality was 1.17 (95% confidence interval [CI]: 1.03-1.33) compared with no BBB. General population with RBBB had an increased risk of cardiac death (HR: 1.43, 95% CI: 1.17-1.74). For patients with RBBB and acute MI, the pooled risk ratio was 2.31 (95% CI: 2.13-2.49) for in-hospital mortality, 2.85 (95% CI: 2.46-3.30) for 30-day mortality, and 1.96 (95% CI: 1.59-2.42) for longer-term mortality. For acute HF patients, the pooled risk ratio of all-cause mortality was 1.11 (95% CI: 1.06-1.16), and for chronic HF patients it was 1.75 (95% CI: 1.38-2.22).
  
  
  CONCLUSIONS
  Right bundle branch block is associated with an increased risk of mortality in general population and patients with heart disease.
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Cardiology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Wenyan
authors.initials: W
authors.lastname: Liu
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Department of Cardiology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Shang
authors.initials: S
authors.lastname: Wang
mesh_terms: D002037:Bundle-Branch Block / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D002423:Cause of Death; D016009:Chi-Square Distribution; D018450:Disease Progression; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors