Miller et al evaluated patients discovered to have asymptomatic bundle branch block (BBB). The authors are from the Mayo Clinic.


Patient selection: uncomplicated bundle branch block (BBB)


The presence of incidentally discovered bundle branch block is associated with increased morbidity and mortality. The risk was greater for left bundle branch block (LBBB).


Additional risk factors affecting cardiovascular morbidity and mortality:

(1) presence of a reduced left ventricular ejection fraction (LVEF)

(2) clinical symptoms related to the BBB

(3) diabetes mellitus

(4) advanced age

(5) other cardiovascular risk factors other than hypertension


Hypertension was associated with reduced risk, possibly because therapy for hypertension had a beneficial effect.


A patient with incidentally discovered bundle branch block should be evaluated more closely, especially if other cardiovascular risk factors are present.


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