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  • Title: [Intraventricular conduction disorders in acute myocardial infarction: early and late clinical significance].
    Author: Hassi M, Kunstmann S, Corbalán R, Arriagada D, Casanegra P.
    Journal: Rev Med Chil; 1989 Dec; 117(12):1381-6. PubMed ID: 2519377.
    Abstract:
    The prognostic impact of new bundle branch block (BBB) upon the intra hospital course and long-term prognosis of patients with acute myocardial infarction (MI) was studied in 517 consecutive patients with a recent MI: 449 patients did not have BBB (group I) and 69 developed a new BBB (group II). Age and sex were similar in both groups. Incidence of BBB among patients with anterior wall MI was 61% compared to 8% in patients with inferior wall MI (p less than 0.05). The distribution of RBBB, RBBB + left anterior hemiblock and LBBB was 32%, 30% and 38% among 46 patients with anterior wall MI, compared to 28%, 6% and 68% among 18 patients with inferior wall MI (p less than 0.05). The level of peak CK values (2345 vs 1437 IU/l), presence of Killip grade III or IV (56 vs 18%), complete A-V block (24 vs 6%) and mortality (34 vs 9%) were significantly higher in group II (p less than 0.05). Long-term mortality at 1 and 5 years of follow up was 29% and 51% in group II patients, a three fold increase over group I. We conclude that development of new BBB during myocardial infarction is associated with a poor immediate and long term prognosis. This may be related to larger infarcts rather than the conduction defect itself.
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