Epidemiological and evolutionary characteristics of heart failure in patients with left bundle branch block - A Moroccan center-based study

Background: in patients with heart failure,left bundle branch block (lbbb) seems to be associated with an increased risk of cardiovascular mortality. purpose: the purpose of this study is to determine the in-hospital outcome of congestive heart failure patients with lbbb versus those without. methods: we conducted a prospective observational study at the department of intensive care and rhythmology at the mohammed v military hospital of rabat,where 330 patients were admitted for heart failure between january 2008 and september 2012. screening out patients with missing data yielded a cohort of 274 patients. among the 274 patients,only 110 had lbbb and a left ventricular ejection fraction lower than 50%. we randomly selected a subset of 110 patients diagnosed as non-lbbb to ensure a significant statistical comparison between lbbb and non-lbbb patients. we therefore considered two groups in our analysis: 110 heart failure (hf) patients with lbbb and 110 hf patients without lbbb. patients with incomplete records were excluded. results: male gender was dominant in both groups (82.7% vs. 66.7%,p=. 0.005). patients with lbbb had a higher prevalence of idiopathic dilated cardiomyopathy (39.1% vs. 4.8%,p<. 0.001); and a higher prevalence of previous hospitalization for heart failure (64.5% vs. 23.3%,p<. 0.001). the left ventricular ejection fraction was significantly lower in the group with lbbb (25.49% vs. 39.53%,p<. 0.001). age,cardiovascular risk factors,rhythmic and thromboembolic complications did not significantly differ. in patients with lbbb,61.8% received cardiac resynchronization therapy performed both during the index hospital stay (50.9%) and previously (10.9%). hospital outcome was marked by 20 in-hospital deaths in the group with lbbb and eight deaths in the group without lbbb (. p=. 0.008). conclusion: our analysis emphasizes increased in-hospital mortality and higher disease severity,over a short period of stay,in heart failure patients with left bundle branch block. © 2014 king saud university.