Photo Credit: Meeter099
The following is a summary of “Influence of Right and Left Bundle Branch Block in Patients With Cardiogenic Shock and Cardiac Arrest,” published in the October 2024 issue of Critical Care by Rusnak et al.
Researchers conducted a retrospective study to assess the impact of right bundle branch block (RBBB) and left bundle branch block (LBBB) on patients with cardiogenic shock (CS) compared to those without bundle branch block (BBB).
They examined adult patients with CS admitted to the ICU and examined the effect of RBBB and LBBB on 30-day mortality and a subgroup of patients with CS and cardiac arrest upon admission.
The results showed that patients with RBBB had the highest 30-day all-cause mortality (72.5%), followed by LBBB (52.9%) and no BBB (50.0%) (log-rank P =0.015). This finding persisted even when analyzing only patients with CS and cardiac arrest (RBBB: 90.0%, LBBB: 73.3%, no BBB: 62.2%; log-rank P =0.008). Multivariable Cox regression analysis of norepinephrine, lactate, Acute Physiology Score, troponin I ,Society of Cardiovascular Angiography & Interventions shock stage, and heart rate revealed that RBBB independently predicted 30-day mortality (hazard ratio [HR], 1.807; 95% CI, 1.107-2.947; P =0.018), while LBBB was not associated, and the analysis for troponin I (HR, 1.003; 95% CI, 1.001-1.005; P =0.001), lactate (HR, 1.065; 95% CI, 1.018-1.115; P =0.006),and Acute Physiology Score (HR, 1.033; 95% CI, 1.001-1.066; P =0.041) were also linked with 30-day all-cause mortality, and no association was found between RBBB and liver or severe renal failure incidence.
Investigators concluded that RBBB was independently associated with increased 30-day all-cause mortality in patients with CS, even after adjusting for other prognostic factors like Acute Physiology Score, lactate, and troponin I, while LBBB had no impact.
