On the other hand, the patient with a trueLBBB had significant dyssynchrony and the latest activation under lead V8 during spontaneous rhythm. The patient with IVCD presented with minimal interventricular dyssynchrony and the latest activation under V5. doi:10.1016/j.amjcard.2008.08.069.Studied patients differed in their UHF-ECG ventricular activation sequence during spontaneous rhythm and RVSP.

Usefulness of baseline electrocardiographic QRS complex pattern to predict response to cardiac resynchronization. The effect of cardiac resynchronization on morbidity and mortality in heart failure. doi:10.1056/NEJMoa032423.Ĭleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, Tavazzi L. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. doi:10.1001/jama.2.īristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, Carson P, DiCarlo L, DeMets D, White BG, DeVries DW, Feldman AM. Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, Wilkoff B, Canby RC, Schroeder JS, Liem LB, Hall S, Wheelan K. Cardiac resynchronization in chronic heart failure. Mechanical dyssynchrony and QRS morphology are associated with outcome following CRT.Ībraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, Loh E, Kocovic DZ, Packer M, Clavell AL, Hayes DL, Ellestad M, Trupp RJ, Underwood J, Pickering F, Truex C, McAtee P, Messenger J.

Non-LBBB patients with dyssynchrony had a more favourable long-term survival than non-LBBB patients who lacked dyssynchrony. Right bundle branch block patients who lacked dyssynchrony had the least favourable outcome. However, non-LBBB patients with dyssynchrony had a more favourable event-free survival than those without dyssynchrony: radial dyssynchrony hazard ratio 2.6, 95% confidence interval (CI) 1.47-4.53 (P = 0.0008) and IVMD hazard ratio 4.9, 95% CI 2.60-9.16 (P = 0.0007). Of 248 (98%) with follow-up, LBBB patients had a significantly more favourable long-term survival than non-LBBB patients. Radial dyssynchrony was observed in 85% of the patients with LBBB, 59% with IVCD*, and 40% with RBBB* (*P < 0.01 vs. Of 254 with baseline quantitative echocardiographic data available, 128 had LBBB, 81 had intraventricular conduction delay (IVCD), and 45 had right bundle branch block (RBBB). Dyssynchrony assessed before CRT included interventricular mechanical delay (IVMD) and speckle-tracking radial strain using pre-specified cut-offs for each. The pre-specified primary endpoint was death, heart transplant, or left ventricular assist device over 4 years. Two-hundred and seventy-eight consecutive New York Heart Association class III and IV CRT patients with QRS ≥120 ms and ejection fraction ≤35% were studied. Because benefits of cardiac resynchronization therapy (CRT) appear to be less favourable in non-left bundle branch block (LBBB) patients, this prospective longitudinal study tested the hypothesis that QRS morphology and echocardiographic mechanical dyssynchrony were associated with long-term outcome after CRT.

Lbbb vs ivcd