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- Title
Effect of cardiac resynchronization therapy on heart failure patients with different morphologies of left bundle branch block in ECG.
- Authors
LIN Yanyu; WU Dongyan; XU Jing; CHEN Bingwei
- Abstract
Objective To compare the efficacy of cardiac resynchronization therapy (CRT) on chronic heart failure (CHF) patients with different left bundle branch block (LBBB) morphologies. Methods Patients (n=45) who were treated with CRT were enrolled. According to the intrinsic ECG morphologies, patients were divided into 1) "genuine" LBBB group (n=32) who present negative dominant V1 and V2 lead wave (QS or rS); mid-QRS notching or slurring in at least 2 leads of V1, V2, V5, V6, I and aVL as well as QRS duration ≥140 ms in male or ≥130 ms in female and 2) "false" LBBB group (n=10) who meet traditional standards but fail to meet "genuine" LBBB diagnostic standard. The QRS duration, echocardiographic indices and New York Heart Association (NYHA) Functional Classification were evaluated at the 12 months follow-up. CRT responder was defined as patient with ≥1 decrease in NYHA class and/or with ≥15% reduction in left ventricular end-systolic volume (LVESV). CRT super-responder was defined as patient with ≥30% reduction in LVESV. Results There was no difference in basic characteristics of patients between groups. At the 12 months follow-up, 20 patients in "genuine" LBBB group and 6 patients in "false" LBBB group were identified as responders (P > 0.05). Compared with those in "false" LBBB group, the responders in "genuine" LBBB group showed better improvement in left ventricular ejection fraction and left ventricular end diastolic diameter (LVEDD) (both P < 0.05). Conclusion Left bundle branch block morphology is less predictive for the efficacy of CRT. However, patients who show response to CRT with "genuine" LBBB profile may get more benefits from CRT treatment than the patients with "false" LBBB profile.
- Subjects
CARDIAC pacing; HEART failure treatment; ELECTROCARDIOGRAPHY; LEFT heart ventricle; HEMODYNAMICS
- Publication
Tianjin Medical Journal, 2015, Vol 43, Issue 4, p432
- ISSN
0253-9896
- Publication type
Article
- DOI
10.11958/j.issn.0253-9896.2015.04.027