Friday, September 19, 2008

Left Bundle Branch Blocks


When are they dangerous? when this is a new finding on ECG (and in the right clinical context), this is suggestive of an acute MI.

What about in asymptomatic patients? In those with known or suspected coronary artery disease, a LBBB is an independent predictor of mortality.

What about left ventricular function? with a LBBB, the LV is often dis-synchronized, and will have a decreased LV ejection fraction.

Anything else? yes, exercise stress testing with a known LBBB is of limited value.

Factoids? rarely you may see a rate-related LBBB. Slow the heart down a bit and it disappears. This may be a predictor for major cardiac events, however there is some controversy over this.

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