Clinical importance of complete left bundle branch block with left QRS axis deviation

Objective:To elucidate the diagnostic significance of left axis deviation (LAD) in patients(pts) with chronic(6months)left bundle branch block(LBBB) Methods:we retrospectively studied 56 pts in our hospital from 1992 The evaluation included a complete history, physical examination, chest X ray films, serial 12 lead electrocardiograms(ECG),2D echocardiograms and Doppler studies Results: 23 pts had left axis deviation(LAD)and 33 pts had normal axis without axis deviation Among LAD pts, 9 had previous left anterior fascicular block 8 pts started with LBBB without axis deviation, but later ECGs showed LBBB with LAD 6 pts showed LBBB with LAD when they took ECG examination in our hospital and there were no former ECG recorders as control Compared with normal axis pts ,the average disease period of hypertension and diabetes mellitus are much longer in LAD pts There are statistically significant difference in tricuspid valve disease and aortic disease and ventricular enlargement in LBBB with LAD compared to normals These results show that LBBB with LAD has severe organic heart disease Conclusion:These findings point towards a exact clinical significance in LBBB with LAD Under this condition, the significance of LBBB with LAD should be taken seriously in clinic practice.