Arrhythmias & electrophysiology
Impact of bundle branch block morphology on outcomes of patients with syncope and bifascicular block: A SPRITELY (POST 3) substudy
Authors' conclusion
In patients with syncope and bifascicular block, pacemaker implantation reduces adverse events as compared with ILR monitoring, irrespective of the type of BBB or the presence of PR interval prolongation.
Study context
- Population
- Patients with syncope and bifascicular block
- Participants
- 115 patients
- Comparison
- Empiric pacemaker implantation vs ILR monitoring, by bundle branch block (BBB) morphology
- Primary endpoint
- Major study-related events (MSREs)
Methodological detailsmulticentre, subgroup analysis
- Multicentre
- Subgroup analysis
Primary result
As reported in the abstract
- Pacemaker vs ILR: P = 0.001
- Pacemaker vs ILR: P < 0.0001
- Pacemaker vs ILR: P < 0.0001
- Pacemaker vs ILR: P = 0.002
- Subgroups: left BBB 41 (36%); Right bundle branch block (RBBB) + left anterior fascicular block 69 (60%); RBBB + left posterior fascicular block 5 (4%)
Further findings
Predictors of outcomes within ILR group
- BBB type not a predictor of recurrent syncope
- P = 0.30
- BBB type not a predictor of bradycardia requiring pacemaker
- P = 0.15
- BBB type not a predictor of major study-related events (MSREs)
- P = 0.42
- PR interval prolongation did not predict MSREs
- P = 0.22
- QRS width did not predict MSREs
- P = 0.96
Original publication
Impact of bundle branch block morphology on outcomes of patients with syncope and bifascicular block: A SPRITELY (POST 3) substudy. Heart Rhythm. Published 29 September 2022. doi:10.
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