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Newly Acquired Right Bundle-Branch Block: The Framingham Study

JOHN F. SCHNEIDER, M.D.; H. EMERSON THOMAS Jr., M.D.; BERNARD E. KREGER, M.D.; PATRICIA M. McNAMARA; PAUL SORLIE; and WILLIAM B. KANNEL, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Patricia M. McNamara; The Framingham Heart Study, 118 Lincoln Street; Framingham, MA 01701.


Framingham and Boston, Massachusetts; and Bethesda, Maryland


©1980 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1980;92(1):37-44. doi:10.7326/0003-4819-92-1-37
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Cardiovascular abnormalities were identified prospectively in all 70 persons who developed complete right bundle-branch block (RBBB) in The Framingham Study during 18 years of biennial follow-up. Most were hypertensive before the appearance of RBBB. Although the initial appearance of RBBB was usually unaccompanied by overt clinical events, the subsequent incidence of coronary disease and congestive failure was two and one-half and four times greater, respectively, than that in matched control subjects without RBBB. The incidence of cardiovascular disease mortality was almost three times greater in persons who developed RBBB than in an age-matched sample of the population-at-large. This excess of cardiovascular disease mortality was related primarily to the high prevalence of associated cardiovascular abnormalities. Only 21% remained free from clinically apparent cardiovascular abnormalities. A QRS duration of ≥ 130 ms and a QRS axis between -45° and -90° identified those most likely to have associated cardiovascular abnormalities.

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