{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T16:47:13Z","timestamp":1780764433503,"version":"3.54.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Right bundle\u2010branch block (RBBB) occurs in 0.2% to 1.3% of people and is considered a benign finding. However, some studies have suggested increased risk of cardiovascular morbidity and mortality. We sought to evaluate risk attributable to incidental RBBB in patients without prior diagnosis of cardiovascular disease (CVD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We reviewed the Mayo Clinic Integrated Stress Center database for exercise stress tests performed from 1993 to 2010. Patients with no known CVD\u2014defined as absence of coronary disease, structural heart disease, heart failure, or cerebrovascular disease\u2014were selected. Only Minnesota residents were included, all of whom had full mortality and outcomes data. There were 22\u00a0806 patients without CVD identified; 220 of whom (0.96%) had RBBB, followed for 6 to 23\u00a0years (mean 12.4\u00b15.1). There were 8256 women (36.2%), mean age was 52\u00b111\u00a0years; and 1837 deaths (8.05%), including 645 cardiovascular\u2010related deaths (2.83%), occurred over follow\u2010up. RBBB was predictive of all\u2010cause (hazard ratio [HR], 1.5; 95% CI, 1.1\u20132.0;\n              <jats:italic>P<\/jats:italic>\n              =0.0058) and cardiovascular\u2010related mortality (HR,1.7; 95% CI, 1.1\u20132.8;\n              <jats:italic>P<\/jats:italic>\n              =0.0178) after adjusting for age, sex, diabetes mellitus, hypertension, obesity, current and past history of smoking, and use of a heart rate\u2010lowering drug. Patients with RBBB exhibited more hypertension (34.1% versus 23.7%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0003), decreased functional aerobic capacity (82\u00b125% versus 90\u00b124%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), slower heart rate recovery (13.5\u00b111.5 versus 17.1\u00b19.4\u00a0bpm;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001), and more dyspnea (28.2% versus 22.4%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0399) on exercise testing.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with RBBB without CVD have increased risk of all\u2010cause mortality, cardiovascular\u2010related mortality, and lower exercise tolerance. These data suggest RBBB may be a marker of early CVD and merit further prospective evaluation.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.017430","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T09:08:09Z","timestamp":1600074489000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Mortality in Patients With Right Bundle\u2010Branch Block in the Absence of Cardiovascular Disease"],"prefix":"10.1161","volume":"9","author":[{"given":"Prakriti","family":"Gaba","sequence":"first","affiliation":[{"name":"Department of Medicine Columbia University Medical Center New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Pedrotty","sequence":"additional","affiliation":[{"name":"Department of Medicine Hospital of the University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher V.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic College of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda R.","family":"Bonikowske","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic College of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Allison","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic College of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2283-4340","authenticated-orcid":false,"given":"Suraj","family":"Kapa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic College of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.10.050"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.191095"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/postgradmedj-2016-133950"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078808"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00267-2"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.12.005"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr291"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.10.007"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.10.008"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022339"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs291"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.06.060"},{"key":"e_1_3_1_14_2","first-page":"323","article-title":"Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation","volume":"3","author":"Bruce RA","year":"1971","unstructured":"Bruce RA. Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res. 1971;3:323\u2013332.","journal-title":"Ann Clin Res"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/1995-705X.172197"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.14.10069"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000034670.06526.15"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.017430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:50:04Z","timestamp":1715601004000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.017430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,6]]},"references-count":16,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2020,10,6]]}},"alternative-id":["10.1161\/JAHA.120.017430"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.017430","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,6]]},"assertion":[{"value":"2020-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e017430"}}