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6th Edition of Cardiology World Conference

September 15-17, 2025 | London, UK

September 15 -17, 2025 | London, UK
Cardio 2025

Prognostic impact of right bundle branch block in acute anterior wall STEMI: A cross-sectional study

Muhammad Abubakar, Speaker at Heart Conferences
University Hospital Birmingham, United Kingdom
Title : Prognostic impact of right bundle branch block in acute anterior wall STEMI: A cross-sectional study

Abstract:

Background: Right Bundle Branch Block (RBBB) in acute Anterior Wall ST-Segment Elevation Myocardial Infarction (AW-STEMI) may indicate extensive myocardial injury, yet its independent prognostic value remains uncertain.

Methods: We conducted a cross-sectional observational study at the Punjab Institute of Cardiology, Lahore, from January 2022 to June 2023. A total of 349 patients with AW- STEMI were stratified into two groups based on the presence or absence of RBBB on initial electrocardiogram. Baseline demographics, comorbidities, and reperfusion strategies were recorded. Primary outcome was in-hospital mortality. Secondary outcomes included cardiogenic shock, cardiac arrest, arrhythmias, Complete Heart Block (CHB), post-MI angina, and duration of hospital stay. Logistic regression was used to adjust for confounding variables.

Results: RBBB was present in 50 patients (14.3%). Baseline age and comorbidities (hypertension, diabetes, CKD, dyslipidemia, prior MI) were similar across groups. Compared with non-RBBB patients, those with RBBB had lower mean LVEF (40.9% vs 45.7%, p< 0.001) and higher peak troponin-I levels (33.5 vs 24.3 ng/mL, p<0.001). In-hospital mortality was significantly higher with RBBB (16% vs 5.7%, OR 3.16, 95% CI 1.28–7.78, p=0.009). Cardiogenic shock (36% vs 16.4%, OR 2.67, p=0.003) and arrhythmias (42% vs 19.7%, OR 2.95, p=0.001) were also significantly increased. Although rates of cardiac arrest (16% vs 11.4%), CHB (12% vs 8%), and post-MI angina (24% vs 15.4%) were higher in RBBB, these differences did not reach statistical significance. Notably, all RBBB patients managed with thrombolysis or conservative therapy died, whereas primary PCI markedly improved survival.

Conclusion: RBBB in AW-STEMI is associated with higher in-hospital mortality, cardiogenic shock, and arrhythmias, reflecting greater hemodynamic instability. Primary PCI offers a significant survival benefit in this high-risk subgroup, underscoring the importance of urgent invasive management.

Biography:

Dr. Muhammad Abubakar graduated in 2017 from Sharif Medical and Dental College, Pakistan. He is currently enrolled in the Fellowship of the College of Physicians and Surgeons Pakistan (FCPS) in Cardiology, having completed three years of training in Pakistan and Currently working as international training fellow in Cardiology in the United Kingdom. His research interests focus on acute coronary syndromes, conduction abnormalities, and imaging in structural heart disease. He has presented work at national and international forums and remains dedicated to advancing evidence-based cardiovascular care and involvement in research work.

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