{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:51:35Z","timestamp":1792011095283,"version":"4.4.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Medtronic Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Incidental left bundle branch block (iLBBB) is a frequent cause for cardiology referrals. In such instances, there is uncertainty as to its prognosis. We sought to determine the utility of cardiovascular magnetic resonance (CMR) in the risk stratification of patients with iLBBB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Clinical events were collected in patients with iLBBB who had CMR. Controls had no cardiac symptoms or cardiac disease, a normal CMR scan and electrocardiogram. Amongst patients with iLBBB [n\u2009=\u2009193, aged 62.7\u2009\u00b1\u200912.6\u2009years (mean \u00b1 SD)], 110\/193 (56.9%) had an abnormal phenotype (iLBBBCMR+) and 83\/110 (43.0%) had a normal phenotype (iLBBBCMR\u2212). Over 3.75\u2009years (median; inter-quartile range: 2.7\u20135.5), iLBBBCMR+ had a higher total mortality [adjusted hazard ratio (aHR) 6.49, 95% confidence interval (CI) 1.91\u201322.0] and total mortality or major adverse cardiac events (MACEs; aHR 9.15, 95% CI 2.56\u201332.6) than controls (n\u2009=\u2009107). In contrast, iLBBBCMR\u2212 had a similar risk of total mortality compared with controls, but total mortality or MACEs was higher (aHR 4.24, 95% CI 1.17\u201315.4; P\u2009=\u20090.028). Amongst iLBBB patients, both myocardial fibrosis (aHR 5.15, 95% CI 1.53\u201317.4) and left ventricular ejection fraction (LVEF) \u2009\u2264\u200950% (aHR 3.88, 95% CI 1.67\u20139.06) predicted total mortality. Myocardial fibrosis plus LVEF\u2009\u226450% was associated with the highest risk of total mortality (aHR: 9.87, 95% CI 2.99\u201332.6) and total mortality or MACEs (aHR 3.98, 95% CI 1.73\u20139.11).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Outcomes in iLBBBCMR+ were poor whereas survival in iLBBBCMR\u2212 was comparable with controls. Myocardial fibrosis and LVEF &amp;lt;50% had an additive effect on the risk of clinical outcomes. A CMR scan is pivotal in risk-stratifying patients with iLBBB.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa008","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T12:24:39Z","timestamp":1578572679000},"page":"956-963","source":"Crossref","is-referenced-by-count":12,"title":["Prognosis of incidental left bundle branch block"],"prefix":"10.1093","volume":"22","author":[{"given":"Abbasin","family":"Zegard","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osita","family":"Okafor","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7160-2074","authenticated-orcid":false,"given":"Joseph","family":"de Bono","sequence":"first","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5687-2535","authenticated-orcid":false,"given":"Richard","family":"Steeds","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3039-4878","authenticated-orcid":false,"given":"Lucy","family":"Hudsmith","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2841-8022","authenticated-orcid":false,"given":"Berthold","family":"Stegemann","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Jani","sequence":"first","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5558-5358","authenticated-orcid":false,"given":"Howard","family":"Marshall","sequence":"first","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0161-674X","authenticated-orcid":false,"given":"Ben","family":"Holloway","sequence":"first","affiliation":[{"name":"Department of Cardiology, Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2176-0223","authenticated-orcid":false,"given":"Francisco","family":"Leyva","sequence":"first","affiliation":[{"name":"Department of Cardiology, Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"key":"2020060505002125700_euaa008-B1","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/clc.20034","article-title":"Left bundle-branch block\u2013pathophysiology, prognosis, and clinical 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