PROGNOSIS IN PATIENTS WITH LEFT-BUNDLE-BRANCH BLOCK AND NORMAL DIPYRIDAMOLE TL-201 SCINTIGRAPHY

Background. The presence of complete left bundle branch block (LBBB) i s commonly associated with a poorer prognosis, especially in patients with coronary artery disease (CAD), Im the general population with sus pected CAD and normal intraventricular conduction, a normal dipyridamo le-thallium scintigraphy is a strong marker of a favorable outcome. Ob jective. Our objective was to assess the prognosis in patients with LB BB and a normal dipyridamole thallium-201 scintigram. Population and m ethods. Patients with complete LBBB and normal myocardial perfusion on dipyridamole SPECT thallium-201 scintigraphy performed in our center for suspected CAD between 1988 and 1995 were monitored for clinical ev ents. Results. Sixty-nine patients (36 women and 33 men) with a mean a ge of 59 years (range 56 to 61) were monitored for a mean period of 33 months (range 25 to 35), During this period, 4 patients had unstable angina, 2 of whom underwent myocardial revascularization. There were n o deaths or myocardial infarction, All events occurred at least 2 year s after the thallium-201 scintigraphy. Conclusion. The presence of a n ormal myocardial perfusion with dipyridamole thallium-201 scintigraphy in this group of patients with suspected CBD and LBBB was associated with a very good prognosis, a flow rate of clinical events occurring o nly 2 years after the myocardial scintigraphy, and no hard events.