Résumé
In patients with heart failure, left bundle branch block [LBBB] seems to be associated with an increased risk of cardiovascular mortality. The purpose of this study is to determine the in-hospital outcome of congestive heart failure patients with LBBB versus those without. We conducted a prospective observational study at the Department of Intensive Care and Rhythmology at the Mohammed V Military Hospital of Rabat, where 330 patients were admitted for heart failure between January 2008 and September 2012. Screening out patients with missing data yielded a cohort of 274 patients. Among the 274 patients, only 110 had LBBB and a left ventricular ejection fraction lower than 50%. We randomly selected a subset of 110 patients diagnosed as non-LBBB to ensure a significant statistical comparison between LBBB and non-LBBB patients. We therefore considered two groups in our analysis: 110 heart failure [HF] patients with LBBB and 110 HF patients without LBBB. Patients with incomplete records were excluded. Male gender was dominant in both groups [82.7% vs. 66.7%, p = 0.005]. Patients with LBBB had a higher prevalence of idiopathic dilated cardiomyopathy [39.1% vs. 4.8%, p < 0.001]; and a higher prevalence of previous hospitalization for heart failure [64.5% vs. 23.3%, p < 0.001]. The left ventricular ejection fraction was significantly lower in the group with LBBB [25.49% vs. 39.53%, p < 0.001]. Age, cardiovascular risk factors, rhythmic and thromboembolic complications did not significantly differ. In patients with LBBB, 61.8% received cardiac resynchronization therapy performed both during the index hospital stay [50.9%] and previously [10.9%]. Hospital outcome was marked by 20 in-hospital deaths in the group with LBBB and eight deaths in the group without LBBB [p = 0.008]. Our analysis emphasizes increased in-hospital mortality and higher disease severity, over a short period of stay, in heart failure patients with left bundle branch block