Electrocardiographic Abnormality Associated With Increased Risk Of Atrial Fibrillation, Congestive Heart Failure

Date: Apr-17-2013"Left anterior fascicular block (LAFB) is considered a benign electrocardiographic (ECG) finding, but its long-term consequences have not been comprehensively studied," writes Mala C. Mandyam, B.S., of the University of California, San Francisco and colleagues.

As reported in a Research Letter, the authors investigated the long-term outcomes of participants with LAFB in the absence of manifest cardiovascular disease in the Cardiovascular Health Study (CHS). Established in 1989, CHS is a prospective cohort study of individuals 65 years of age or older sampled from Medicare eligibility lists nationwide. Of the 1,664 participants who met the criteria for this analysis, the 39 individuals (2.3 percent) with baseline LAFB were older and more likely male. At follow-up (median [midpoint] 16 years), 380 participants had developed atrial fibrillation (AF); 328, congestive heart failure (CHF); and 954 had died. Sixteen participants (41 percent) with LAFB developed AF; 17 (44 percent), CHF; and 33 (85 percent) died. After adjusting for various factors, LAFB remained significantly associated with AF, CHF, and death.

"Given previous histopathological studies, these findings suggest that LAFB may be a clinically relevant marker of an individual's propensity to left heart fibrosis. Further research is needed to determine if LAFB is an important predictor of consequent adverse outcomes," the authors write.
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