Nasyrova Zarina Akbarovna (1), Ergashzoda Erkin Ergashevich (2)
The article examines the prognostic significance of cardiac conduction disorders (atrioventricular block, intracardiac conduction delay, prolonged QRS, presence of left or right bundle branch block) in patients with cardiovascular pathology. Based on modern data, there is an association of these ECG indicators with the risk of adverse outcomes - death, hospitalization for heart failure, development of arrhythmias, and other complications. Pathophysiological mechanisms, possible clinical scenarios, and the practical significance of early detection of conduction disorders for risk stratification and medical tactics adjustment are discussed. Recommendations for further research and integration of these markers into the comprehensive assessment of cardiological patients are presented.
1. Glikson M., Nielsen J.C., et al. 2021 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy. Eur Heart J. 2021;42 (35):3427-3520. (PubMed)
2. Chung M.K., Huang W., et al. 2023 HRS/APHRS/LAHRS guideline on cardiac physiological pacing. Heart Rhythm. 2023. (heartrhythmjournal.com)
3. Kusumoto F.M., Schoenfeld M.H., et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay. Circulation. 2019;140:e382-e482. (PubMed)
4. ESC. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023, 44 (38):3720-3826. (European Society of Cardiology)
5. McDonagh T.A., et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail. 2021;23:387-413. (European Society of Cardiology)
6. Rankinen J., et al. QRS duration and mortality/new-onset HF in ECG-LVH: population-based cohort. BMJ Open. 2022;12:e053477. (BMJ Open)
7. Feng J., et al. Prognostic value of QRS duration in dilated cardiomyopathy: meta-analysis. Front Cardiovasc Med. 2023. (PMC)
8. Zareei M., et al. Can prolonged PR interval predict clinical outcomes in HF? Systematic review. BMC Cardiovascular Disorder. 2024. (PMC)
9. Ali Z.S., et al. PR prolongation as a predictor of atrial fibrillation onset: cohort data. Int J Cardiol. 2024. (ScienceDirect)
10. Kronberg F.O., et al. Native QRS duration and outcomes in HFmrEF. Clin Res Cardiol. 2025. (SpringerLink)
11. Beghini A., et al. 2024 update in heart failure: PR interval and AV dyssynchrony (HOPE-HF). ESC Heart Fail. 2025. (Wiley Online Library)
12. Achten A., et al. Ventricular conduction disorders in HFpEF: prevalence and prognosis. ESC Heart Fail. 2025. (PMC)
13. Li Y., et al. Prognostic model in HF incorporating QRS: development/validation. BMC Cardiovascular Disorder. 2025. (BioMed Central)
14. Saint Croix G.R., et al. Pre-existing RBBB and outcomes after TAVR. Am J Cardiol. 2020. (PubMed)
15. Faroux L., et al. Conduction disorders after TAVR and long-term outcomes. J Am Coll Cardiol: Cardiovasc Interv<3. 2020. (PubMed)
16. Megaly M., et al. New-onset persistent LBBB after TAVR: mortality and HF hospitalization. Am J Cardiol. 2020. (PubMed)
17. Rao K., et al. Prognostic relevance of new bundle branch block after TAVI: systematic review/meta-analysis. Cardiol J. 2024. (PMC)
18. Zheng C., et al. PR interval (short/long/temporal changes) and risk of cardiac events & mortality: meta-analysis. Cardiovasc Res. 2025. (PMC)
19. Gelbenegger G., et al. Bundle branch block and cardiovascular mortality in chronic coronary syndrome. Heart Rhythm. 2024. (ScienceDirect)
20. Yang X., et al. First-degree AV block associated with HF and death in stable CAD: cohort. Int J Cardiol. 2024. (ScienceDirect)
21. Higuchi S., et al. Prognostic implication of first-degree AV block in HCM. J Am Heart Assoc. 2020. (Aha Magazine)
22. Oldroyd S.H., et al. First-degree heart block. StatPearls. 2023 (updated). (NCBI)
23. Medscape. First-degree Atrioventricular Block: Overview & Prognosis. Updated. 2024. (Medscape)
24. Behnoush A.H., et al. ACC/AHA/HFSA 2022 vs. ESC 2021 HF guidance: comparative review. ESC Heart Fail. 2022. (PMC)
25. ACC. Key points from 2021 ESC CRT/pacing guideline (clinical summary). 2021. (American College of Cardiology)
26. ESC/EHRA consensus update: AV dyssynchrony and prolonged PR in HFrEF. Europace. 2025. (OUP Academic)
27. Rankinen/ECG-LVH cohort (confirms increased risk when QRS increases). BMJ Open. 2022. (BMJ Open)
28. Zuin M., et al. RBBB and mortality in hospitalized COVID-19 patients: meta-analysis. Anatol J Cardiol. 2021. (PMC)
29. Bussink B.E., et al. Right bundle branch block in the general population: prevalence, risk factors, outcome. Eur Heart J. 2013. (A classic study for reference.) (OUP Academic)
30. Yang Y., et al. New permanent bundle-branch block and long-term prognosis post-TAVR. Front Cardiovasc Med. 2022. (PMC)
31. Alencar J.N., et al. LBBB in ACS: diagnostic accuracy and in-hospital mortality (systematic review/meta-analysis). Arq Bras Cardiol. 2025. (ABC Cardiol)
32. Yamamoto R., et al. PR interval as a therapeutic target of ivabradine in systolic HF: hypothesis/observations. J Clin Med. 2024. (MDPI)
33. Sartorio A., et al. QTc prolongation predicting mortality on admission (control over the influence of BBB excluded): observational study. J Clin Med. 2024. (PubMed)
34. Stepinska J., et al. ACVC Clinical Decision-Making Toolkit: ECG patterns & risk per 2023 ESC ACS Guideline. ESC, 2023. (European Society of Cardiology)
35. Michowitz Y., et al. '10 commandments' for the 2021 ESC pacing/CRT guidelines (expert review). Eur Heart J. 2021;42 (42):4295-4297. (OUP Academic)