The National Hospital Discharge Register and the national register on rights to reimbursements for medication costs were linked to the Health 2000 Survey data. The Health 2000 sample comprised 8028 individuals (3637 men and 4391 women) aged 30+, of whom 79% (6354 individuals 2876 men and 3478 women) participated in the health examination. The implementation of the survey is described in detail elsewhere ( 15, 16). For the population aged ≥ 80 years, the sampling probability was twice as high as among those < 80 years. The survey was carried out in 2000–2001, and a representative stratified random cluster sample of the Finnish population was examined. This study is based on the Health 2000 Study, which is a major Finnish health examination survey. The aim of the present study was to establish the prognostic significance of eight different IVCDs in a population-based cohort. The ECG is an important tool for the prediction of positive response to this relatively new treatment modality. The number of heart failure patients who are potential candidates for cardiac resynchronization therapy (CRT) is increasing, and this fact has resulted in growing interest in IVCDs among clinicians ( 14). Regarding the prognostic impact of incomplete LBBB (ILBBB), left posterior hemiblock (LPHB), or the R-R′ pattern in the general population, data are scarce or non-existent. In a population study from ECGs taken between 19, the presence of prolonged duration of the QRS complex in a 12-lead ECG and non-specific IVCD was a predictor of mortality ( 13). In a population study, left anterior hemiblock (LAHB) was associated with cardiac morbidity and mortality ( 8), while other authors consider LAHB in a healthy population as an incidental ECG finding ( 12). Previous authors found no increased overall mortality in RBBB in the absence of clinically overt cardiac disease ( 11). In a recent population study, right bundle branch block (RBBB) was associated with increased CV risk and all-cause mortality, whereas incomplete RBBB (IRBBB) was not ( 10). However, there is no consensus on LBBB-related prognosis in general populations ( 9). LBBB may also be a marker of structural heart disease, especially dilated cardiomyopathy ( 7, 8). In several studies on chronic and acute coronary artery disease, left bundle branch block (LBBB) was found to be an excellent predictor of mortality and future clinical events ( 5, 6). Accordingly, the prognostic implications of IVCDs depend on the category of conduction disturbance and on the population studied. In studies performed in healthy populations, findings about future cardiovascular (CV) events have not been consistent ( 3, 4). The epidemiological data have mostly been derived from hospitalized patients with findings partly dependent on the characteristics of the patient cohort ( 2). Published data regarding the clinical and prognostic significance of intraventricular conduction delays (IVCD) are highly varied. In the early days of electrocardiography (ECG), it was noticed that subjects with wide QRS could live decades without remarkable symptoms ( 1). RBBB did not have an impact on cardiovascular mortality either in subjects with or without previous heart disease. In the general population, non-specific IVCD, LBBB, and IRBBB were associated with increased relative risk for all-cause and cardiovascular mortality. Right bundle branch block (RBBB) was not related to additional mortality, while incomplete RBBB (IRBBB) presented a hazard ratio of 2.24 (95% CI 1.064–4.77, P = 0.036).Ĭonclusions. In Cox regression analysis after adjustment for age and gender, the hazard ratio for cardiovascular mortality for non-specific IVCD was 4.25 (95% confidence interval 1.95–9.26, P < 0.0001) and for left bundle branch block (LBBB) 2.11 (95% CI 1.31–3.41, P = 0.002). For both sexes, all-cause and cardiovascular mortality was higher in subjects with IVCD than in those without. During a mean 8.2 years (interquartile range 8.1 to 8.3) of follow-up 640 subjects died (10.2%) 277 (4.4%) were cardiovascular deaths. Data were collected from 6299 Finnish individuals. We examined the prognostic impact of eight different intraventricular conduction delays (IVCD) in the standard electrocardiogram (ECG) in a community cohort.
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