Left bundle branch block causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]; Aarti Narayan, M.B.B.S [4]; Ogheneochuko Ajari, MB.BS, MS [5]


Left bundle branch block is a cardiac conduction seen on the electrocardiogram (ECG) whereby there is an impairment of transmission of the cardiac electrical impulse along the fibers of the left main bundle branch, or both the left anterior fascicle and the left posterior fascicle. Most causes of LBBB are the result of some form of cardiac disease but LBBB is also known to be associated with non cardiac causes.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Alcoholic cardiomyopathy, aortic insufficiency, aortic stenosis, aortic valve replacement, Chagas disease, coronary artery disease, dilated cardiomyopathy, endocarditis, exercise-induced LBBB, heart failure, hemochromatosis, hyperkalemia, hypertension, hypertensive cardiomyopathy, hypertrophic cardiomyopathy, hypertrophic obstructive cardiomyopathy (HOCM), ischemic cardiomyopathy, ischemic heart disease, left ventricular hypertrophy, left ventricular noncompaction (LVNC), left ventricular outflow tract surgery, Lenegre's disease, Lev's disease, lyme disease, myocardial infarction, myocardial ischemia, myocarditis, postpartum cardiomyopathy, restrictive cardiomyopathy, rheumatic fever with aortic valve involvement, sarcoidosis, septal myomectomy, TAVI, valvular heart disease
Chemical / poisoning No underlying causes
Dermatologic Lyme disease, rheumatic fever with aortic valve involvement, sarcoidosis, scleroderma
Drug Side Effect Digoxin toxicity, Pramipexole
Ear Nose Throat No underlying causes
Endocrine Hemochromatosis
Environmental No underlying causes
Gastroenterologic Chagas disease, hemochromatosis, scleroderma
Genetic Hemochromatosis
Hematologic Hemochromatosis
Iatrogenic No underlying causes
Infectious Disease Chagas disease, endocarditis, lyme disease
Musculoskeletal / Ortho Hemochromatosis, scleroderma
Neurologic Chagas disease, hemochromatosis, lyme disease
Nutritional / Metabolic Hyperkalemia
Obstetric/Gynecologic No underlying causes
Oncologic No underlying causes
Opthalmologic Chagas disease, hypertension, sarcoidosis
Overdose / Toxicity Digoxin toxicity
Psychiatric No underlying causes
Pulmonary Scleroderma
Renal / Electrolyte Hyperkalemia, hypertension
Rheum / Immune / Allergy Rheumatic fever with aortic valve involvement, sarcoidosis, scleroderma
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Exercise-induced LBBB, sarcoidosis

Causes of LBBB in Alphabetical Order


  1. 1.0 1.1 1.2 Imanishi R, Seto S, Ichimaru S, Nakashima E, Yano K, Akahoshi M (2006). "Prognostic significance of incident complete left bundle branch block observed over a 40-year period". The American Journal of Cardiology. 98 (5): 644–8. doi:10.1016/j.amjcard.2006.03.044. PMID 16923453. Unknown parameter |month= ignored (help)
  2. Nakajima M, Aomi S, Matsuda N, Kasanuki H, Endo M, Kurosawa H (2003). "Simultaneous biventricular pacemaker implantation for a surgical case of aortic regurgitation with severe left ventricular dysfunction and left bundle branch block". The Journal of Thoracic and Cardiovascular Surgery. 125 (5): 1167–9. doi:10.1067/mtc.2003.304. PMID 12771896. Unknown parameter |month= ignored (help)
  3. Wieslander B, Wu KC, Loring Z; et al. (2013). "Localization of myocardial scar in patients with cardiomyopathy and left bundle branch block using electrocardiographic Selvester QRS scoring". Journal of Electrocardiology. doi:10.1016/j.jelectrocard.2013.02.006. PMID 23540937. Unknown parameter |month= ignored (help)
  4. 4.0 4.1 Arce M, VAN Grieken J, Femenía F, Arrieta M, McIntyre WF, Baranchuk A (2012). "Permanent pacing in patients with Chagas' disease". Pacing and Clinical Electrophysiology : PACE. 35 (12): 1494–7. doi:10.1111/pace.12013. PMID 23078655. Unknown parameter |month= ignored (help)
  5. Grimm W (2012). "Prophylactic implantable defibrillators in dilated cardiomyopathy". Herz. 37 (8): 859–66. doi:10.1007/s00059-012-3687-9. PMID 23052902. Unknown parameter |month= ignored (help)
  6. Foell D, Jung BA, Germann E; et al. (2013). "Segmental myocardial velocities in dilated cardiomyopathy with and without left bundle branch block". Journal of Magnetic Resonance Imaging : JMRI. 37 (1): 119–26. doi:10.1002/jmri.23803. PMID 22987362. Unknown parameter |month= ignored (help)
  7. Stein R, Ho M, Oliveira CM; et al. (2011). "Exercise-induced left bundle branch block: prevalence and prognosis". Arquivos Brasileiros De Cardiologia. 97 (1): 26–32. PMID 21552647. Unknown parameter |month= ignored (help)
  8. Iscove NN, Yan XQ (1990). "Precursors (pre-CFCmulti) of multilineage hemopoietic colony-forming cells quantitated in vitro. Uniqueness of IL-1 requirement, partial separation from pluripotential colony-forming cells, and correlation with long term reconstituting cells in vivo". Journal of Immunology (Baltimore, Md. : 1950). 145 (1): 190–5. PMID 2358672. Unknown parameter |month= ignored (help)
  9. Kutyifa V, Pouleur AC, Knappe D; et al. (2013). "Dyssynchrony and the risk of ventricular arrhythmias". JACC. Cardiovascular Imaging. 6 (4): 432–44. doi:10.1016/j.jcmg.2012.12.008. PMID 23579010. Unknown parameter |month= ignored (help)
  10. Cinca J, Mendez A, Puig T; et al. (2013). "Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure". European Journal of Heart Failure. doi:10.1093/eurjhf/hft042. PMID 23512097. Unknown parameter |month= ignored (help)
  11. Hanson EH, Shue PM, Palm-Leis A, Rowley RK (2001). "An aviator with cardiomyopathy and genetic susceptibility to hereditary hemochromatosis: a case report". Aviation, Space, and Environmental Medicine. 72 (10): 924–7. PMID 11601557. Unknown parameter |month= ignored (help)
  12. Rodrigues B, Correia E, Ferreira Santos L; et al. (2013). "Left bundle branch block, atrioventricular block, torsade de pointes and long QT syndrome: is this too much for a rare cardiomyopathy?". Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology. doi:10.1016/j.repc.2012.06.018. PMID 23618687. Unknown parameter |month= ignored (help)
  13. Gerecke B, Engberding R (2012). "[Isolated noncompaction cardiomyopathy with special emphasis on arrhythmia complications]". Herzschrittmachertherapie & Elektrophysiologie (in German). 23 (3): 201–10. doi:10.1007/s00399-012-0226-6. PMID 23008085. Unknown parameter |month= ignored (help)
  14. 14.0 14.1 Davies MJ (1976). "Pathology of chronic A-V Block". Acta Cardiologica. Suppl 21: 19–30. PMID 1087803.
  15. http://onlinelibrary.wiley.com/doi/10.1111/j.1540-8159.1990.tb04009.x/abstract
  16. Di Bella G, Florian A, Oreto L; et al. (2012). "Electrocardiographic findings and myocardial damage in acute myocarditis detected by cardiac magnetic resonance". Clinical Research in Cardiology : Official Journal of the German Cardiac Society. 101 (8): 617–24. doi:10.1007/s00392-012-0433-5. PMID 22388951. Unknown parameter |month= ignored (help)
  17. Deluigi CC, Ong P, Hill S; et al. (2013). "ECG findings in comparison to cardiovascular MR imaging in viral myocarditis". International Journal of Cardiology. 165 (1): 100–6. doi:10.1016/j.ijcard.2011.07.090. PMID 21885134. Unknown parameter |month= ignored (help)
  18. Kumar PD, Sahasranam KV, Chandrasekharan KG (1993). "Deceleration--dependent left bundle branch block in rheumatic carditis". The Journal of the Association of Physicians of India. 41 (3): 171–2. PMID 8226603. Unknown parameter |month= ignored (help)
  19. Yahalom M, Jerushalmi J, Roguin N (1990). "Adult acute rheumatic fever: a rare case presenting with left bundle branch block". Pacing and Clinical Electrophysiology : PACE. 13 (1): 123–7. PMID 1689027. Unknown parameter |month= ignored (help)
  20. Dechering DG, Kochhäuser S, Wasmer K; et al. (2013). "Electrophysiological characteristics of ventricular tachyarrhythmias in cardiac sarcoidosis versus arrhythmogenic right ventricular cardiomyopathy". Heart Rhythm : the Official Journal of the Heart Rhythm Society. 10 (2): 158–64. doi:10.1016/j.hrthm.2012.10.019. PMID 23070261. Unknown parameter |month= ignored (help)
  21. Femenía F, Arce M, Arrieta M (2010). "[Systemic sclerosis complicated with syncope and complete AV block]". Medicina (in Spanish; Castilian). 70 (5): 442–4. PMID 20920962.
  22. Urena M, Mok M, Serra V; et al. (2012). "Predictive factors and long-term clinical consequences of persistent left bundle branch block following transcatheter aortic valve implantation with a balloon-expandable valve". Journal of the American College of Cardiology. 60 (18): 1743–52. doi:10.1016/j.jacc.2012.07.035. PMID 23040577. Unknown parameter |month= ignored (help)
  23. Colombo A, Latib A (2012). "Left bundle branch block after transcatheter aortic valve implantation: inconsequential or a clinically important endpoint?". Journal of the American College of Cardiology. 60 (18): 1753–5. doi:10.1016/j.jacc.2012.07.034. PMID 23040576. Unknown parameter |month= ignored (help)

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