Clinical Profile Of Left Bundle Branch Block In Tertiary Care Hospital- A Cross Sectional Study

Abstract

Background and Objectives LBBB is a cardiac conduction defect in which activation of left ventricle is delayed which causes left ventricle to contract later than right ventricle. The objective of the study is to assess the aetiology, clinical features and left ventricular functions on 2D ECHO in patients with LBBB. Methodology The present one year cross sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum on 100 patients diagnosed to have LBBB on ECG, during the period of January 2018 to December 2018. A detailed history, physical examination and routine laboratory investigations were done. ECG and 2DECHO were obtained, QRS duration measured, and was compared to EJECTION FRACTION on 2DECHO. Results The mean age of the patients was 63.12 years. Prevalence of LBBB was slightly greater in males. The most common presenting complaint was Breathlessness. Hypertension, diabetes mellitus and smoking were noted to be commonly associated with LBBB. The most common etiology for LBBB was found to be ischemic heart disease. QRS duration, ejection fraction and Left ventricle diameters were found to be statistically significant in association with etiology of LBBB. Left ventricular systolic and diastolic dysfunction was a common finding present in patients with LBBB. Most common valvular lesion associated with LBBB was mitral regurgitation as per our study. QRS duration had a negative correlation with ejection fraction which was statistically significant. Among the patients who were subjected to coronary angiography, single vessel disease was found to be the most common lesion. The most common vessel implicated was left anterior descending followed by right coronary artery. Conclusion and interpretation LBBB is a cardiac conduction defect which causes both LV systolic and Diastolic dysfunction leading to decreased cardiac performance. Most common presenting symptom is breathlessness and the most common etiology is IHD. QRS duration has a negative correlation with ejection fraction and forms the basis for CRT. Every patient presenting with LBBB should be subjected to extensive cardiac workup to rule out any underlying serious cardiac condition.