Work

Predictive Effect of Atypical Right Bundle‐Branch Block on In‐Hospital Sudden Cardiac Death and Cardiac Rupture and Long‐Term Prognosis in Patients With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

Year: 2025

Type: article

Abstract: Background A study was conducted to explore the predictive effect of atypical right bundle‐branch blocks (ARBBB) on in‐hospital sudden cardiac death (SCD), cardiac rupture (CR), and long‐term prognosis in patients with acute myocardial infarction undergoing percutaneous coronary intervention with a drug‐eluting stent. Methods and Results A total of 13 886 patients with first‐episode acute myocardial infarction who underwent percutaneous coronary intervention with a drug‐eluting stent at 3 centers from January 2017 to January 2022 were included in this retrospective study. Patients were categorized into 4 groups: ARBBB (n=348), typical right BBB (n=374), left BBB (n=366), and non‐BBB (n=12 798). The primary end points were in‐hospital SCD and CR, the secondary end points were 2‐year major adverse cardiovascular and cerebrovascular events. During the in‐hospital observation period, 334 patients (2.4%) experienced SCD, with 98 (0.7%) attributed to CR. The incidences of in‐hospital SCD and CR in the group with ARBBB were significantly higher than those in the other 3 groups (ARBBB versus left BBB versus typical right BBB versus non‐BBB: SCD, 10.6% versus 5.7% versus 4.3% versus 2.0%, P =0.001; CR, 5.7% versus 2.7% versus 1.3% versus 0.5%, P <0.001). ARBBB was a statistically significant predictor of in‐hospital SCD (hazard ratio [HR], 2.45 [95% CI, 1.65–4.78], P< 0.001) and CR (HR, 3.32 [95% CI, 1.77–7.74], P< 0.001). ARBBB could also predicted the 2‐year major adverse cardiovascular and cerebrovascular events (HR, 2.99 [95% CI, 1.65–5.53], P< 0.001). Conclusions ARBBB is a predictor of in‐hospital SCD, CR, and 2‐year major adverse cardiovascular and cerebrovascular events in patients with first‐episode acute myocardial infarction undergoing percutaneous coronary intervention with a drug‐eluting stent.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.124.038344