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Electrocardiographic abnormality may increase risk for AF, congestive HF
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Left anterior fascicular block may be a clinically relevant marker of left heart fibrosis, researchers reported in JAMA.
“Left anterior fascicular block is considered a benign electrocardiographic finding, but its long-term consequences have not been comprehensively studied,” according to the research letter.
Researchers conducted a long-term outcomes analysis of individuals with left anterior fascicular block in the absence of manifest CVD using data from the Cardiovascular Health Study, a prospective cohort study of individuals aged 65 years or older from nationwide Medicare eligibility lists.
Of the 1,664 participants included in the analysis, the 39 participants with baseline left anterior fascicular block were older and more likely to be male.
During a mean follow-up of 16 years, 380 participants developed AF, 328 congestive HF and 954 died. Forty-one percent of participants with left anterior fascicular block developed AF, 44% developed congestive HF and 85% died. After adjustment for factors such as age, race and BMI, left anterior fascicular block continued to be associated with AF (HR=1.89; 95% CI, 1.11-3.24), congestive HF (HR=2.43; 95% CI, 1.44-4.12) and death (HR=1.57; 95% CI, 1.08-2.26). In addition, left anterior fascicular block was associated with death limited to CV causes (HR=2.02; 95% CI, 1.08-3.77), according to the research letter.
Analysis of 10 years of annual ECGs revealed that four participants with left anterior fascicular block developed right bundle branch block, none developed left bundle branch block and two exhibited pacing.
“Given previous histopathological studies, these findings suggest left anterior fascicular block may be a clinically relevant marker of an individual’s propensity to left heart fibrosis,” the researchers wrote.
Disclosure: Susan R. Heckbert, MD, PhD, reports receiving grants from the NHLBI. Eric Vittinghoff, PhD, reports consulting for the NIH. The other researchers report no relevant financial disclosures.
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