Abstract：ObjectiveTo explore the pathogeny and prognosis of permanent atrial fibrillation(AF) complicating right bundle branch block(RBBB). MethodsRetrospective analysis was carried out on 128 patients who had been admitted in our hospital from April 2006 to March 2015 and diagnosed with permanent AF complicating RBBB. The pathogeny and prognosis was summarized. ResultsAmong the 128 patients, there were 90 males and 38 females at an average age of (71.13±14.20) years old. Of all the causes, there were 67 cases with valvular heart disease, 18 cases with coronary heart disease, 8 cases with dilated cardiomyopathy, 2 cases with hypertrophic cardiomyopathy, 14 cases with congenital heart disease, 10 cases with hypertension, 9 cases with AF complicating RBBB of unknown cause. The patients diagnosed with valvular heart disease accounted for 52.34% in all the research objects and cases with coronary heart disease accounted for 14.06%. Among all the enrolled patients, 46 cases underwent surgical treatments: 24 accepted valve replacement(including 1 case accepting valve replacement plus pacemaker implantation and 5 cases accepting valve replacement plus radiofrequency ablation of AF), 9 patients were implanted with permanent cardiac pacemaker, 6 patients underwent radiofrequency ablation of AF, 8 patients were implanted with coronary stent, 4 cases underwent repair of atrial septal defect(including 2 cases accepting the surgery alone), 2 cases underwent repair of ventricular septal defect(including 1 case accepting the surgery alone), 1 patient accepted heart transplantation, 1 patient accepted repair of coronaryarterypulmonaryartery fistula. Other patients underwent conservative medication. In 19 patients mainly those with valvular heart disease, coronary heart disease or dilated cardiomyopathy, left ventricle ejection fraction was less than 50%. All the patients were followed up by phone calls or outpatient visits within a period of 1-8 years. During the followup, 50 cases(39.06%) died, 55 cases(42.97%) continued to be followed up in outpatient clinic or accepted regular medication therapy outside the hospital, and 23(17.97%) were at loss of followup due to being out of contact. Twenty patients(15.63%) in all were complicated by cerebral infarction with poor prognosis. ConclusionThe pathogeny of permanent AF complicating RBBB is varied, mainly valvular heart disease. The patients have poor prognosis with various cardiovascular and cerebrovascular complications at high mortality rates.
2018, Vol. 27 
