Left Bundle Branch Block results from ischaemic heart disease in over a quarter of cases. This is particular true for applicants presenting over the age of 45 with a new LBBB. The risk of sudden death in this group is about 10 times that of a control group. A LBBB may manifest as an intermittent rate related phenomenon or be constant.
The discovery of a LBBB requires investigations. Stress ECG alone is unable to exclude ischaemia. Stress echocardiography or myocardial perfusion scan are necessary for that purpose. A stress echocardiography can be difficult to interpret as the LBBB will affect septal motion.
On the first occasion that an applicant presents with LBBB:
On subsequent occasions:
An applicant with LBBB must be considered as having a condition that is of aeromedical significance; unless: