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Heart failure in healthy young people with left bundle branch block: long-term follow-u

Session Poster Session 1

Speaker Luigi Rivetti

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure – Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : L Rivetti (Conegliano,IT), N Sitta (Conegliano,IT), G Allocca (Conegliano,IT), G Turiano (Conegliano,IT), E Lanari (Conegliano,IT), M Centa (Conegliano,IT), P Delise (Peschiera del Garda,IT)

Authors:
L Rivetti1 , N Sitta1 , G Allocca1 , G Turiano1 , E Lanari1 , M Centa1 , P Delise2 , 1Conegliano General Hospital, Cardiologia - Conegliano - Italy , 2Dr. Pederzoli Clinic - Peschiera del Garda - Italy ,

Citation:

Left bundle branch block (LBBB) is generally associated with a poor prognosis if with known ischemic heart disease and / or left ventricular dysfunction. However, the clinical and prognostic significance of the LBBB in young people (age <50 years old) totally asymptomatic and without any comorbidities is not well recognized.

The aim of our study is to evaluate this condition in a long term follow-up.


From 1996 to 2016, a total of 55 (0.27%) have been enrolled from 20,123 patients. Exclusion criteria were: previous history of cardiac arrest, syncope, any known cardiomyopathies, history of angina or dyspnea, known arterial hypertension. All patients underwent annual clinical cardiac evaluation, ECG recording and complete echocardiogram. Whether clinical appropriate, angiographic evaluation, cardiac magnetic resonance (CMR), and electrophysiological study have been performed. The mean age was 36 ± 11.7 years old and 40 (72 %) were male. More than half practiced any sportive activities and 13 (23%) had positive familial history for cardiac sudden death (SD). Considering the coronary clues, an abnormal origin of circumflex artery had been detected in 3 cases; an intramyocardial bridge of the left main coronary artery in 4 cases; and hypoplasia of right coronary artery in 1 case. About the CMR findings, 10 (18%) showed an area of late gadolinium enhancement (LGE), of whom, 9 in the interventricular septum, and 1 in the apical lateral wall. During a mean follow up of 10 ± 16 years, all patients are still alive, except 1 that died for non-cardiovascular causes. Conversely, 3 (5%) had syncope needing of cardiac pacemaker; 1 (2%) developed heart failure with severe left ventricular heart dysfunction needing of cardiac resynchronization therapy; 1 (2%) had ventricular tachycardia needing of implanted cardiac device.


The LBBB in <50 years old without any overt cardiac disease is a very rare condition, predominantly in males, and could be associated to coronary congenital abnormalities or evidence of fibrosis at the CMR. In a long-term follow-up, LBBB seems not to be associated to mortality neither to development of heart failure; conversely, it could be associated to other advanced atrioventricular block.

Number

55

Male sex, n (%)

40 (72)

Sport activities, n (%)

37 (67)

Familial history of juvenile cardiac sudden death, n (%)

13 (23)

Age, years

36 ± 11.7

QRS width, mmsec

132 ± 20

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