Prognosis of patients with chronic bifascicular block.

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Abstract
All conduction disturbances in the bundle branches of the heart may be categorized as unifascicular, bifascicular or trifascicular blocks on the basis of ECG criteria. The bifascicular type appears frequently in asymptomatic patients and in those with bradycardia or atrioventricular [AV] block. Prolonged HQ [His-ventricle] interval on an His bundle electrogram may be an important diagnostic indicator which determines the necessity for temporary or permanent ventricular pacing therapy. Studies of prevention of mortality by prophylactic pacemaker insertion in patients with bifascicular block are summarized. Possible identification by electrophysiologic studies of potential victims of sudden death due to AV block is discussed. Clinical examination and electrophysiologic investigation of neurologic symptoms in evaluation of patients with bifascicular block are related to therapeutic decision-making.