{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T05:06:43Z","timestamp":1746076003937,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T00:00:00Z","timestamp":1489104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"Background<\/jats:title>Previous studies have shown that the presence of left bundle branch block (LBBB<\/jats:styled-content>) is associated with an increased risk of cardiac mortality and heart failure (HF<\/jats:styled-content>). Recently, new criteria to define strict LBBB<\/jats:styled-content> have been proposed: QRS<\/jats:styled-content> duration \u2265140 ms for men and \u2265130 ms for women, along with mid\u2010QRS<\/jats:styled-content> notching or slurring in \u22652 contiguous leads.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>We assessed the prevalence and prognostic significance of LBBB<\/jats:styled-content> according to classical (QRS<\/jats:styled-content> duration \u2265120ms) and strict criteria in permanent pacemaker patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We retrospectively enrolled 723 consecutive patients who had undergone single\u2010 or dual\u2010chamber pacemaker implantation at the study center from July 2002 to December 2014. Patients with a left ventricular ejection fraction \u226435% or a prior diagnosis of HF<\/jats:styled-content> were excluded.<\/jats:p><\/jats:sec>Results<\/jats:title>\nLBBB<\/jats:styled-content> was reported in 54 (7%) patients, and strict\u2010LBBB<\/jats:styled-content> in 15 (2%) patients. During a median follow\u2010up of 48 months (range, 18\u201392 months), 147 (20%) patients reached the combined endpoint of death or HF<\/jats:styled-content> hospitalization. Patients with LBBB<\/jats:styled-content> and those with strict\u2010LBBB<\/jats:styled-content> displayed significantly higher rates of death or HF<\/jats:styled-content> hospitalization (log\u2010rank test, all P<\/jats:italic> < 0.0001). In particular, strict\u2010LBBB<\/jats:styled-content> was associated with the worst outcome. The presence of LBBB<\/jats:styled-content> according to classical definition criteria (hazard ratio [HR<\/jats:styled-content>]\u2009=\u20091.98, confidence interval [CI<\/jats:styled-content>]: 1.23\u20103.19, P<\/jats:italic> = 0.005) and to strict criteria (HR<\/jats:styled-content> = 2.20; CI<\/jats:styled-content>: 1.04\u20104.65; P<\/jats:italic> = 0.039) were both confirmed as independent predictors of death or HF<\/jats:styled-content> hospitalization after adjustment for relevant clinical covariates.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Among patients who had undergone standard pacemaker implantation, the prevalence of LBBB<\/jats:styled-content> was 7% according to classical definition criteria and 2% according to strict criteria. The presence of LBBB<\/jats:styled-content>, and particularly of strict\u2010LBBB<\/jats:styled-content>, at the baseline predicted a poor outcome in terms of death or HF<\/jats:styled-content> hospitalization.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22673","type":"journal-article","created":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T17:43:15Z","timestamp":1489167795000},"page":"377-382","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence and clinical significance of left bundle branch block according to classical or strict definition criteria in permanent pacemaker patients"],"prefix":"10.1002","volume":"40","author":[{"given":"Andrea","family":"Mazza","sequence":"first","affiliation":[{"name":"Cardiology Department Santa Maria della Stella Hospital Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Grazia","family":"Bendini","sequence":"additional","affiliation":[{"name":"Cardiology Department Santa Maria della Stella Hospital Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"De Cristofaro","sequence":"additional","affiliation":[{"name":"Cardiology Department Santa Maria della Stella Hospital Orvieto Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariolina","family":"Lovecchio","sequence":"additional","affiliation":[{"name":"CRM department, Boston Scientific Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"CRM department, Boston Scientific Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Leggio","sequence":"additional","affiliation":[{"name":"Salus Infirmorum Clinic San Filippo Neri Hospital Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine University of Modena and Reggio Emilia, Modena Hospital Modena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,10]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1161\/01.CIR.79.4.845"},{"doi-asserted-by":"publisher","key":"e_1_2_6_3_1","DOI":"10.1016\/S0735-1097(87)80162-6"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1093\/europace\/euu016"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1016\/S0735-1097(01)01302-X"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1111\/j.1540-8167.2007.01014.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_7_1","DOI":"10.1093\/europace\/eut041"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1016\/j.amjcard.2010.11.010"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1016\/j.jacc.2008.12.013"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1093\/europace\/eut132"},{"key":"e_1_2_6_11_1","first-page":"83","article-title":"Pacemaker 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