Cardiac resynchronization therapy in patients with intrinsic and right ventricular pacing-induced left bundle branch block pattern

American Journal of Therapeutics
Xuedong ShenDennis J Esterbrooks

Abstract

We studied 95 consecutive patients, mean age 70 years, who received cardiac resynchronization therapy (CRT) for class III or IV heart failure with a left ventricular (LV) ejection fraction < or =35% and a QRS duration > or =120 ms. Sixty-seven patients had intrinsic left bundle branch block (LBBB) (group 1), and 28 patients had right ventricular pacing-induced LBBB (group 2). The time difference (TPW-TDI) between onset of QRS to the end of LV ejection by pulsed wave Doppler and onset of QRS to the end of systolic wave in the basal segment with greatest delay by tissue Doppler imaging was measured before CRT and at the last follow-up after CRT. TPW-TDI >50 ms was defined as left ventricular mechanical dyssynchrony. A positive response to CRT was defined as LV volume at end-systole decreasing > or =15% after CRT. The percentage of CRT responders in group 2 was significantly greater than that in group 1 (68% versus 42%, P = 0.04) during follow-up of 16 months. After adjusting for age, gender, and clinical features, this pattern of CRT response persisted (P = 0.008). Similarly, there was a greater reduction in QRS duration in group 2 (178 ms) after CRT versus 154 ms for group 1, P = 0.01. There was no significant difference in TPW-...Continue Reading

References

Mar 15, 1997·Journal of the American College of Cardiology·H F Tse, C P Lau
Jan 15, 1997·The American Journal of Cardiology·M C GiudiciJ Sutton
Feb 2, 2002·Journal of the American College of Cardiology·Gerardo AnsaloneMassimo Santini
Nov 13, 2002·Journal of the American College of Cardiology·Maria Vittoria PitzalisPaolo Rizzon
Dec 3, 2004·Journal of Cardiovascular Electrophysiology·Tamara HorwichLeslie Saxon
Aug 9, 2005·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Leopoldo Perez de IslaUNKNOWN RAVE (Registro de Asincronía Ventricular en España-Spanish Ventricular Asynchrony Registry) study investigators
Nov 14, 2006·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Leopoldo Perez de IslaJosé Zamorano

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Citations

Feb 1, 2011·Echocardiography·Xuedong ShenDennis J Esterbrooks
Oct 19, 2016·International Journal of Cardiology·John RickardKaren A Robinson

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