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The European Society of Cardiology

Influence of QRS prolongation on the natural history of CHF

Luigi Padelettia,*, Marzia Giaccardia,b, Federico Turrenia,b, Nicola Musillia, Andrea Colellaa, Paolo Pieragnolia, Antonio Micheluccia, Giuseppe Ricciardia and Maria Cristina Porciania

a Institute of Internal Medicine and Cardiology, University of Florence, Florence, Italy
b Department of Cardiovascular Rehabilitation, Don Gnocchi Foundation, Florence, Italy

Received 3 May 2004; accepted 24 May 2004.

* Luigi Padeletti, Institute of Internal Medicine and Cardiology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. Tel.: +39-055-4277634; fax: +39-055-4378638
elettrofisiologia{at}dfc.unifi.it

Abstract

Aims To evaluate the influence of QRS prolongation on the natural history of chronic heart failure (CHF).

Methods The results of several studies carried out from 1951 to 2003 were analysed.

Results (a) Isolated left bundle branch block (LBBB) is associated with an increased risk of developing cardiovascular disease and increased cardiac mortality; (b) investigations on the effect of right bundle branch block (RBBB) on mortality have yelded conflicting results; (c) the effects of the association of LBBB with left axis deviation (LAD) on further LV function deterioration remain controversial; (d) LBBB in CHF is associated with a significantly higher all-cause and sudden cardiac death mortality.

Conclusions LBBB is unequivocably associated with greater disease severity and mortality in patients with CHF.

Key Words: Heart failure • QRS duration • Bundle branch block • Mortality


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