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European Journal of Heart Failure 2007 9(1):7-14; doi:10.1016/j.ejheart.2006.04.011
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© 2006 European Society of Cardiology

Left bundle branch block as a risk factor for progression to heart failure

Faiez Zannada,*, Etienne Huvelleb, Kenneth Dicksteinc, Dirk J. van Veldhuisend, Christoph Stellbrinke, Lars Køberf, Serge Cazeaug, Philippe Ritterg, Aldo Pietro Maggionih, Roberto Ferrarii,j and Philippe Lechatk

a CIC-INSERM-CHU de Nancy, Hospital Jeanne d'Arc Dommartin-lès-Toul, BP 303 - 54201 Toul Cedex, France
b Guidant CRM Clinical Research Department Brussels, Belgium
c Department of cardiology, Stavanger University Hospital Stavanger, Norway
d Department of Cardiology, University Hospital Groningen Groningen, the Netherlands
e Department of Cardiology, University Hospital RWTH, Aachen, Germany
f Department of Cardiology, Rigshospitalet Heart Centre Copenhagen, Denmark
g Department of Cardiology InParys, Saint-Cloud, France
h ANMCO Research Centre Florence, Italy
i Department of Cardiology, University of Ferrara Ferrara, Italy
j Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS Gussago, Italy
k Clinical Pharmacology Department Pitié-Salpétrière Hospital, Paris, France

* Corresponding author. Tel.: +33 3 83 65 66 25; fax: +33 3 83 65 66 19. f.zannad{at}chu-nancy.fr


  Abstract

The prevalence of conduction disturbances, particularly left bundle branch block (LBBB), is strongly correlated with age and with the presence of cardiovascular disease. LBBB has been reported to affect approximately 25% of the heart failure (HF) population and it is likely that the deleterious role of such conduction disorders in the progression to HF has been underestimated.

The purpose of this article is to review the data from the literature indicating that LBBB may have a causative role, mediated through the resulting intra-ventricular asynchrony, in the deterioration of cardiac function and the development of cardiac remodelling and HF. It also aims to address the potential for future clinical therapies for this conduction disorder.

Key Words: Left bundle branch block • Remodelling • Heart failure • Prevention • Cardiac resynchronisation therapy

Received May 10, 2005; Revised December 9, 2005; Accepted April 25, 2006


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