Pediatric Left Bundle Branch Block Follow-up

  • Author: Bahram Kakavand, MD, FACC; Chief Editor: Stuart Berger, MD   more...
 
Updated: Apr 14, 2010
 

Further Inpatient Care

Continuous telemetry may be considered if the left bundle branch block (LBBB) might be associated with other arrhythmias (see Imaging Studies).

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Further Outpatient Care

Left bundle branch block may rarely progress to complete heart block and sudden death. In these patients, prognosis depends on the associated cardiac disease more than the left bundle branch block itself. Yearly evaluation, including ECG, is recommended, with follow-up more frequent than this if indicated by underlying cardiac disease and changes in patient's clinical course and symptoms.

Patients with left bundle branch block, left axis deviation, and first-degree heart block or left bundle branch block and near-syncope or complete syncope require close follow-up care. They should be referred for consultation with an electrophysiologist and possibly pacemaker insertion.

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Complications

If left bundle branch block progresses to complete heart block, the patient may have syncope or suddenly die.

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Prognosis

Progression to complete heart block is rare, and the prognosis depends on associated cardiac disease more than the left bundle branch block itself. Biventricular pacing may improve clinically significant and progressive morbidity associated with concomitant congestive heart failure.

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Patient Education

For excellent patient education resources, visit eMedicine's Heart Center.

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Contributor Information and Disclosures
Author

Bahram Kakavand, MD, FACC  Assistant Professor of Pediatrics, Pediatric Cardiology and Electrophysiology, University of Kentucky College of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Christopher Johnsrude, MD, MS  Chief, Division of Pediatric Cardiology, University of Louisville School of Medicine; Director, Congenital Heart Center, Kosair Children's Hospital

Christopher Johnsrude, MD, MS is a member of the following medical societies: American Academy of Pediatrics and American College of Cardiology

Disclosure: St Jude Medical Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Alvin J Chin, MD  Professor of Pediatrics, University of Pennsylvania School of Medicine; Attending Physician, Cardiology Division, Children's Hospital of Philadelphia

Alvin J Chin, MD, is a member of the following medical societies: American Association for the Advancement of Science, American Heart Association, and Society for Developmental Biology

Disclosure: Nothing to disclose.

Gilbert Z Herzberg, MD  Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College; Consulting Staff, Department of Pediatrics, Sound Shore Medical Center

Gilbert Z Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Stuart Berger, MD  Professor of Pediatrics, Division of Cardiology, Medical College of Wisconsin; Chief of Pediatric Cardiology, Medical Director of Pediatric Heart Transplant Program, Medical Director of The Heart Center, Children's Hospital of Wisconsin

Stuart Berger, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American College of Chest Physicians, American Heart Association, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Christopher Mart, MD, to the development and writing of this article.

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ECGs show a normal sinus rhythm and a sinus rhythm with a left bundle branch block.
Anatomy of the penetrating portion of the atrioventricular (AV) bundle.
ECG depicts electrophysiologic events in normal cardiac conduction. AV = atrioventricular.
Pathophysiology of left bundle branch block. AV = atrioventricular; LV = left ventricular; RV = right ventricular.
ECG depicts electrophysiologic events of left bundle branch block.
 
 
 
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