right and left bundle branch block life expectancy right and left bundle branch block life expectancy

The heart has two upper (atria) and two lower chambers (ventricles). It began in the age of enlightment (renaissance). This well help them do a better job of spotting changes in your heart. Your healthcare provider will review your electrocardiogram (EKG) results carefully to make sure you dont have a different problem, such as: Usually, if you dont have symptoms and you dont have heart disease, you dont need treatment for right bundle branch block. WebMD does not provide medical advice, diagnosis or treatment. LBBB is associated with slight increase in incidence of heart disease, but it can also be just an isolated electrical abnormality in some people. . When right bundle branch block is detected on an ECG, it can be classified as either a complete block . And usually, left bundle branch block may cause some severe problems. What else does your echo show? When that happens, significant bradycardia (slow heart rate) may eventually develop. Epub 2021 Sep 12. Advertising on our site helps support our mission. The outlook after treatment is fair but without treatment, most patients have a poro quality of life and a shortened life span. See your provider if you have any new symptoms or your symptoms get worse. 1996-2022 MedicineNet, Inc. All rights reserved. . Mayo Clinic. The signal can't travel down this path the way it should. While it takes most people about 6-8 months to recover after a heart attack, overall recovery time depends on your general health, how severe the attack was, the type of treatment you received and when you received it. In one study, 47.7% of people with left bundle branch block also had high blood pressure. The study followed 144,642 individuals who received CRT-D therapy between 2002 and 2008. Left bundle branch block. Disclaimer. doi: 10.1161/JAHA.115.002013. Curr Heart Fail Rep. 2018 Apr;15(2):53-60. doi: 10.1007/s11897-018-0384-x. MedTerms online medical dictionary provides quick access to hard-to-spell and often misspelled medical definitions through an extensive alphabetical listing. Accompanied by three officers, he left the gate, and descended the right bank of the Rhone. If you have heart disease or have been diagnosed with bundle branch block, ask your provider how often you should have follow-up visits. We do not endorse non-Cleveland Clinic products or services. When combined with other risk factors, LBBB is associated with an increased risk of death. Terms of Use. Johns Hopkins Medicine. Healthcare providers diagnose LBBB during an ECG. . Is Mitral Insufficiency life-threatening for patients? Still, BBB is something that might be present in a completely normal heart. For this reason, some experts now routinely use CRT pacemakers (which avoid pacemaker-induced left bundle branch block) in people with reduced ejection fractions who are entirely dependent on permanent pacemakers. There are two main conducting pathways in the heart, the left and the right bundle. Fast Heart Rate, Palpitate, Abnormal and Normal Testing HELP. What are symptoms of heart block and how it is treated? ST-segment elevation is present in leads III and aVF with reciprocal ST . Sudden cardiac arrest - Medical emergency that could be fatal! Normally, the signal goes down both bundle branches at once and both ventricles are working at the same time. Brenyo A, Kutyifa V, Moss AJ, Mathias A, Barsheshet A, Pouleur AC, Knappe D, McNitt S, Polonsky B, Huang DT, Solomon SD, Zareba W, Goldenberg I. RBBB can be a normal finding but it is . These impulses travel along a pathway, including two branches called the right and the left bundles. Bundle branch block. 64,65 This creates an irregular heartbeat. But if both branches are blocked, it may disrupt your hearts electrical activity. 57. Healthcare providers dont always treat bundle branch blocks. Electrical impulses that cause your heart to beat (contract) start in the heart's upper right chamber (right atrium) and travel to the lower chambers (ventricles). A right bundle branch block (RBBB) refers to a total or partial blockage of the right branch of the hearts conduction system. Med. The complications of bundle branch block are similar whether the blockage is on the right or left side of your heart, but for people who have a left side bundle . 1975; 51:477-484. For the left and right ventricles to contract at the same time, an electrical impulse must travel down the right and left bundle branches at the same speed. https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/cardiac-resynchronization-therapy-crt. https://www.uptodate.com/contents/search. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. This study emphasizes the prognostic significance of echocardiographic assessment of left ventricular volume after CRT implantation in LBBB patients with mild HF. A cardiac electrophysiologist (a subspecialized cardiologist, specifically trained to manage abnormal heart rhythms) places this device under the skin of your chest. JAHA. Recommended low-intensity exercises for those with heart disease include indoor cycling, rowing, ellipticals, walking and water aerobics. The portion of the ECG called the QRS complex represents the electrical impulse distributed across the ventricles. Your hearts two ventricles usually contract at the same time. Normal resting heart rate (RHR) values can range from anywhere between 60-100 beats per minute (bpm). Exclusion Criteria: No informed consent. However, certain things can increase the risk of developing the disease, including: LBBB mainly affects older adults. What if your liver is not filtering and have lBBB. Guidelines support cardiac resynchronization therapy with a defibrillator (CRT-D) in mild heart failure (HF) patients with left bundle branch block (LBBB). https://www.merckmanuals.com/professional/cardiovascular-disorders/arrhythmias-and-conduction-disorders/bundle-branch-block-and-fascicular-block. Because the ventricles arent working at exactly the same time, this creates an irregular heartbeat (arrhythmia.). Medical Professional. Most of the time, doctors can not identify a cause for dilated cardiomyopathy. The 2 upper chambers are called atria, and the 2 lower chambers are called ventricles. 2012;60(14):1297-1313. doi:10.1016/j.jacc.2012.07.009, Baldasseroni S, Opasich C, Gorini M, et al. Some of the risk factors that can increase the chance of getting the right bundle branch block include: Right bundle branch block (RBBB) blocks the electrical signaling of the heart, so signaling problems can gradually lead to: Because RBBB may alter the electrical activity of the heart, it may create obstacles to identify other heart diseases, such as heart attacks. Bundle branch block: There is a flaw in the bundle branches, the pathways for the electrical impulse running along the right and left . In someone whose heart is otherwise healthy, this reduced function may be trivial. Well, I would lie if I would tell you that you have nothing to worry about. Muscle Mass Found To Be More Important Than BMI, 3 Common Types Of Heart Attack Treatments. You may opt-out of email communications at any time by clicking on laryssa124271249 Prognostic impact of bundle branch block after acute coronary syndrome. In the U.S., 1 in every 4 deaths is caused by heart disease. The lack of blood supply means the heart does not get enough oxygen or nutrients. Start by exercising for 15 minutes, four times per week, and slowly work yourself up to 30-minute sessions. Am J Cardiol. It may lead to delays in proper management of those heart conditions. A heart attack is a layperson's term for a sudden blockage of a coronary artery. J Am Heart Assoc. I ended up at a cardiologist and had an echocardiogram and stress test. 3) Activation of the RV originates across the septum. For the heart to beat efficiently,both ventriclesshould contract simultaneously. The patients should be in NYHA functional class I, II or III. The cause for bundle branch blocks can differ depending on whether the left or the right bundle branch is affected. https://www.uptodate.com/contents/search. Verywell Health's content is for informational and educational purposes only. Most people with LBBB do not experience symptoms directly related to LBBB. By Richard N. Fogoros, MD Left bundle branch block (LBBB) is an abnormal pattern seen on anelectrocardiogram (ECG). J Insur Med. Description. The long-term cardiac prognosis of 24 clinically healthy men with complete right bundle branch block, identified from the 1,142 men constituting the population of the Baltimore Longitudinal Study on Aging, was assessed over a follow-up period averaging 8.4 years. Echocardiographic hypo-responders had increased risk of all-cause mortality compared with echocardiographic + clinical responders (hazard ratio [HR] 2.85, 95% confidence interval [CI]: 1.37 to 5.94, p = 0.005). Eight patients had left bundle-branch block (LBBB), four had right bundle-branch block (RBBB), and seven had a prolonged RP interval, and one patient showed complete heart block. A right bundle branch block (RBBB) refers to a total or partial blockage of the right branch of the heart 's conduction system. Be sure to follow your providers treatment plan for the best results. But if youve already had heart failure or a heart attack along with right bundle branch block, it puts you at a higher risk of death. It sometimes makes it harder for the heart to pump blood to the rest of the body. What is heart block and how it can be prevented? Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. eds. 34:1497, 1951.Crossref. A bundle branch block (BBB) is when something blocks or disrupts the electrical signal that causes your heart to beat. For people without underlying heart disease, treatment may not be necessary. There are several causes of right bundle branch block, including: A provider often finds it during an annual physical. Two-hundred fifty patients (47%) were echocardiographic hypo-responders and 27 patients (5%) were clinical hypo-responders. The bundle branch block (BBB) is an alteration of the ventricular conduction that may lead into a ventricular dyssynchrony and to heart failure (HF) [].Its usual to see these abnormal ventricular conduction with HF, since BBB and HF most of the time share the same ethyology []; about one third of the patients with this comorbidity have a BBB identified with by your QRS complex . 2002;143(3):398-405. doi:10.1067/mhj.2002.121264. Right bundle branch block is an obstacle in your right bundle branch that makes your heartbeat signal late and out of sync with the left bundle branch, creating an irregular heartbeat. Is Bacterial endocarditis life-threatening heart disease? the indications are essentially unchanged and it remains a potentially life-saving . It is usually harmless unless accompanied by severe heart disease. There is a problem with LBBB is a condition wherecardiac electrical impulsesdo not distribute in a balanced way. EKG discovered right bundle branch block! Bundle branch block is a condition in which there's a delay or blockage along the pathway that electrical impulses travel to make the heart beat. Reduce your blood pressure, if its high. Get useful, helpful and relevant health + wellness information. heart health center/heart a-z list/how serious is a right bundle branch block article. Changes in branch structure, such as stretching. A heart block does not mean that the heart stops beating altogether, because other 'back-up' systems can take over. Cardiology, Emergency Medicine. We do not endorse non-Cleveland Clinic products or services. Unable to load your collection due to an error, Unable to load your delegates due to an error. Seek medical treatment immediately if you have: A bundle branch block (BBB) is a blockage or disruption to the electrical signal that causes your heart to beat. This content does not have an English version. With a snap, the pouch's weight left her neck as Radagon hefted the spoils of her journey. However, cardiac resynchronization therapy (CRT) or a pacemaker may be options for those with an underlying condition. What is a left bundle branch block on ECG? A left bundle branch block usually is a sign of an underlying heart disease , including dilated cardiomyopathy, hypertrophic cardiomyopathy, high blood pressure, aortic valve disease, coronary artery . Is Constrictive Pericarditis life threatening heart disease? J Assoc Physicians India. It can substantially improve cardiac efficiency in people with LBBB and heart failure. For example, with left bundle branch block, the wide QRS complex appears upright in certain leads and downward in others. Skipped heartbeats and a slower-than-normal heart rate may result. American Heart Journal. If you have symptoms such as fainting, your provider may suggest a pacemaker. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury. Friday, January 27, 2023. Epub 2012 Nov 24. Risk factors for bundle branch block include: If both the right and the left bundles are blocked, the main complication is a complete blockage of the electric signaling from the upper to the lower chambers of the heart. Peix A, Karthikeyan G, Massardo T, Kalaivani M, Patel C, Pabon LM, Jimnez-Heffernan A, Alexanderson E, Butt S, Kumar A, Marin V, Mesquita CT, Morozova O, Paez D, Garcia EV. They are the pathways that spread the heart's electrical impulse evenly through the ventricles, ensuring the coordinated contraction of the two ventricles. PMC With left bundle branch block, the bundle branch that distributes the electrical impulse to the left ventricle is wholly or partially blocked. 1-ranked heart program in the United States. Permanent atrial fibrillation, flutter or tachycardia (>100 bpm). To continue reading this article, you must log in. A heart attack can cause chest pain, heart failure, and electrical instability of the heart. Its also a good idea to carry a copy of your EKG that shows you have LBBB in case of an emergency, like a heart attack. This type of pacemaker helps both of your ventricles contract at the same time. In recent years, some evidence has suggested that people with reduced left ventricular ejection fractions with permanent pacemakers may have an increased risk of developing heart failure due to the pacemaker-induced left bundle branch block. There are certain structures, called valves, present in the heart to regulate the flow of blood into, within, and out of the heart. Impulses, or electrical signals, travel through both the left and right chambers of your heart to make it pump. Left bundle branch block (LBBB) is an abnormal pattern seen on an electrocardiogram (ECG). Sometimes, there is no known cause. Understanding your heart rate and what's healthy for you is an important part of taking care of yourself. A left bundle branch block may be the first sign of a complete heart block. Heart Rhythm. 2015 Jun 29;4(7):e002013. For this reason alone, people with LBBB should make sure they have regular medical checkups. However, an RBBB that develops after a heart attack in a previously normal heart is a matter of concern. As cardiovascular fitness increases, the resting heart rate value decreases. The pathway includes two branches the left and the right bundles. But having right bundle branch block can put you at a higher risk of death if you also have heart failure or a heart attack. Bundle branch block and fascicular block. Tobin et al 2 reviewed 30 cases of alcoholic cardiomyopathy. Supariwala AA, Po JR, Mohareb S, et al. It's caused by a problem with the electrical pulses that control how your heart beats. However, the incidence of a de novo left bundle branch block (LBBB) remains very high, ranging from 5% to 40% depending on the type of valve used.1-3 It is one of the most common complications of this procedure. As a result, the heart beats irregularly. There was no difference in baseline heart failure diagnosis between groups. J Am Coll Cardiol. Last reviewed by a Cleveland Clinic medical professional on 08/09/2021. Next, the signal goes to your atrioventricular (AV) node and bundle branches, which make your left and right ventricles tighten. Sept. 28, 2020. Make sure your provider knows about your BBB diagnosis if you have: You may want to carry a copy of your EKG, so you have it handy if an emergency happens. Created for people with ongoing healthcare needs but benefits everyone. Echocardiographic hypo-response was defined as 35% reduction (median) in left ventricular end-systolic volume 1 year after CRT-D implantation without evidence of clinical hypo-response. Because bundle branch block affects the electrical activity of the heart, it can sometimes complicate the accurate diagnosis of other heart conditions, especially heart attacks. In that case, you might require a permanent pacemaker. Right bundle branch block (RBBB) is an abnormality of the electrical conducting system of the heart. If your cardiologist spots LBBB on an EKG, they may run tests to figure out the cause. Salden OAE, Vernooy K, van Stipdonk AMW, Cramer MJ, Prinzen FW, Meine M. JACC Clin Electrophysiol. If you were diagnosed with LBBB, be sure to have a cardiac evaluation to look for underlying heart disease. Diagnosed with both Right bundle branch block and sinus bradycardia? Left Bundle Branch Block: Current and Future Perspectives. Atrioventricular delay programming and the benefit of cardiac resynchronization therapy in MADIT-CRT. This can be a sign of underlying heart disease. Pacemaker insertion. A typical QRS duration is between 60-100 ms. A 2021 study of 76,220 individuals finds that the median QRS duration was 86 ms. More specifically, it indicates that the cardiac electrical impulse is not distributed across the heart's ventricles in the usual way. These include: Youre at higher risk of death if you have a bundle branch block along with: Chest pain along with a new left bundle branch block may indicate a serious underlying health condition, such as a heart attack. . Accessibility Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the . But your cardiologist will look into treatment options if youve had: Blocks typically form on one side. A medical emergency, such as a heart attack. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. In patients with heart failure (HF) and a significantly reduced left ventricular ejection fraction (LVEF), left bundle branch block (LBBB) has been associated with an increase in mortality (1).Fortunately, cardiac resynchronization therapy (CRT) has proven to be of benefit in mitigating the dyssynchrony caused by the LBBB 2, 3, 4, 5.The proven reduction in mortality, HF symptoms, and HF . In right bundle branch block, there is a problem with the right branch of the conducting system that sends the electrical signal to the right ventricle. Treatment options Diagnosis. American Heart Association. An increasing number of papers, most based on epidemiology, have shown a strong association between bundle branch block (BBB) and cardiovascular disease, more specifically hypertension, cardiomegaly, coronary artery disease, and heart failure.Left BBB (LBBB) has been associated with cardiovascular disease complications in a much larger number of cases if compared to Right BBB (RBBB). J Am Coll Cardiol. Conduction system : Right bundle branch block refers to a change in the electrical conduction system of heart. 3) Note appropriate discordance in V1 with ST elevation and upright T wave. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Cookies collect information about your preferences and your devices and are used to make the site work as you expect it to, to understand how you interact with the site, and to show advertisements that are targeted to your interests. Bundle Branch Block. Cardiomyopathy. A new left bundle branch block should warrant work-up for a prior heart attack. Learn what foods help protect your cardiovascular system from heart attack, coronary heart disease, stroke, and cardiovascular disease. National Library of Medicine Mayo Clinic is a not-for-profit organization. Which dietary changes are necessary after right bundle branch block diagnosis? Rest assured that not everyone with LBBB has heart disease, but it is important to rule it out. Cleveland Clinic is a non-profit academic medical center. Many people have right bundle branch block, especially as they age. The latest information about heart & vascular disorders, treatments, tests and prevention from the No. Conduction disorders. At the initial visit with the cardiologist he explained to me the difference between the left and right block and that the left was more serious because it was generally the result of damage or heart di Schneider JF, Thomas HE Jr, Kreger BE, et al. Federal government websites often end in .gov or .mil. However, in people who have heart failure and aleft ventricular ejection fraction reduced to less than 50%, left bundle branch block can produce a significant drop-off in cardiac efficiency. The signal then travels through the left atrium to the ventricles. There is a rSR' complex in lead V1 and right axis deviation with qR complexes in lead III and rS complexes in lead I and aVL. Strategies to Improve Selection ofPatients Without Typical LeftBundleBranch Block for CardiacResynchronization Therapy. The QRS is wide at 154 ms. Learning about this potentially deadly condition may save a life. the unsubscribe link in the e-mail. The right bundle branch sends the signal to the right ventricle of the heart. Bundle branch block (BBB) is a block or disruption to the electrical impulse that contracts your hearts lower chambers. The LBBB itself causes the heart to work a bit less efficiently, which makes a big difference in people with certain heart disease types. 1979;90(3):303-310. doi:10.7326/0003-4819-90-3-303, Linde C, Braunschweig F. Cardiomyopathy and LeftBundleBranchBlock: A Farewell to Drugs? Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Is Brugada syndrome life-threatening and is it hereditary? Sauer WH. 2018 Jan 23;71(3):318-320. doi:10.1016/j.jacc.2017.11.039, Glikson M, Nielsen JC, Kronborg MB, et al. Clinical hypo-response was defined as HF event in the first year after CRT-D implantation. This signal starts in the sinoatrial (SA) node, which tells your left and right atria (upper heart chambers) to contract. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site. Newly acquired left bundle-branch block: The Framingham study. The risk of both right bundle branch block and left bundle branch block increases with age and other health conditions, such as heart disease. Many times, bundle branch blocks dont cause any symptoms, though they sometimes lead to dizziness or fainting. MeSH Anyone can have a bundle branch block. Impulses, or electrical signals, travel through both the left and right chambers of your heart to make it pump. 1, 2 The detrimental effect of LBBB on left ventricular systolic and diastolic function caused by regional delays of electrical activity leads to dyssynchronous left ventricular function and has been established in HF patients. Please enable it to take advantage of the complete set of features! New Engl J Med. A newly diagnosed left bundle branch block may indicate an underlying health condition that requires medical evaluation and treatment. So, the U.S. and U.K. restrict pilots with LBBB from flying an airplane. During an early landmark study in cardiology, 89% of the people who developed left bundle branch block were subsequently diagnosed with some form of significant cardiovascular disease. If you dont have heart disease, having right bundle branch block doesnt change your life expectancy or add to your risk level. Inflammation of the heart muscle (myocarditis), Thickened, stiffened or weakened heart muscle (cardiomyopathy), Blood clot in the lungs (pulmonary embolism), Heart structure problems that are present at birth (congenital heart defects) such as a hole in the wall separating the upper chambers of the heart (atrial septal defect), High blood pressure in the pulmonary arteries (pulmonary hypertension). Significance. You can lower your risk of BBB and other heart problems by staying healthy and making smart choices. Find out more about other types of heart block from the British Heart Foundation. The SA node is present in the upper right chamber of the heart. The Heart's Electrical System: Anatomy and Function, An Overview of Dilated Cardiomyopathy Heart Failure, How to Treat Wide and Narrow Tachycardia in the Field, Importance of the Atrioventricular (AV) Node, Left bundle branch block: From cardiac mechanics to clinical and diagnostic challenges, 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities, Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure, New ECG criteria for acute myocardial infarction in patients with left bundle branch block, Etiology and left ventricular functions in left bundle branch block - a prospective observational study, Newly acquired left bundle-branch block: The Framingham study. Right bundle branch block is a problem with your right bundle branch that keeps your hearts electrical signal from moving at the same time as the left bundle branch. The human heart contracts thanks to the sinoatrial node, which acts as a natural pacemaker, sending an electrical impulse through the heart. The signal still gets to the right ventricle, but it is slowed down, compared to the left bundle. Lightheadedness, Headache And Spacey Feeling, Types Of Arrhythmia: 7 Ways Your Heart Can Get Out Of Rhythm, 8 Things You Didn't Know About Irregular Heartbeat (Arrhythmia) And Atrial Fibrillation, But Should. 2021 Feb;10(5):e017619. Echocardiography. Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure. This is called a bundle branch block. Its more likely to happen in older people. However, a CRT pacemaker or permanent pacemaker may be necessary when a heart condition is present, especially heart failure. Epub 2019 Jan 25. The patient should present a complete left bundle branch block (LBBB) with QRS duration of >120ms. Careers. On the other hand,right bundle branch block does not imply an underlying heart condition. In these cases, the left bundle branch block is considered a benign, incidental ECG finding. Patients with a dilated cardiomyopathy and low ejection fraction who have significant heart failure with a LBBB and a QRS duration >130 ms. (https://www.ahajournals.org/doi/10.1161/CIRCEP.119.008239). The signal still gets to the right ventricle, but it . BBB causes an irregular heartbeat. Right bundle branch block (RBBB) is a condition in which electricity does not flow normally down the bundle of tissue that acts as a wire on the right side of the heart. Biton Y, Zareba W, Goldenberg I, Klein H, McNitt S, Polonsky B, Moss AJ, Kutyifa V; MADITCRT Executive Committee. over a year ago, Guest If we combine this information with your protected MedicineNet does not provide medical advice, diagnosis or treatment. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Around 0.06-0.1% of the general population has LBBB. Johns Hopkins Medicine. Left bundle branch block (LBBB) is a finding on an electrocardiogram . Your heart has 4 chambers. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Relation of bundle branch block to long-term (four-year) mortality in hospitalized patients with systolic heart failure. But more commonly, heart block develops later in life. Left Bundle Branch Block with Spontaneous Remission After at Least 3 Years , Ann. Many women think that the typical signs of a heart attack like crushing chest pain and shortness of breath can be easily recognized and cannot be missed. The electrical signal can't travel down this path the way it normally would. Often, but not always, the presence of LBBB indicates an underlying heart condition. ESC Scientific Document Group, 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA),European Heart Journal, Volume 42, Issue 35, 14 September 2021, Pages 34273520,doi:10.1093/eurheartj/ehab364. However, in some cases, the presence of LBBB may indicate an underlying heart condition. A total of 75 patients (28.3%) died over a follow up time of 9.9 years. LBBB was associated with significantly worse mortality (hazard ratio [HR], 1.17; 95% confidence interval [CI], 1.00-1.36), an LVEF drop to 35% or less (HR, 1. . These are termed right bundle branch and left bundle branch.