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Related Experiment Videos

Variable left ventricular activation pattern in patients with heart failure and left bundle branch block.

J W-H Fung1, C-M Yu, G Yip

  • 1Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China. jwhfung@cuhk.edu.hk

Heart (British Cardiac Society)
|December 17, 2003
PubMed
Summary

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Left ventricular (LV) activation patterns in heart failure patients with left bundle branch block (LBBB) vary significantly. Understanding these diverse LV activation sequences is crucial for effective cardiac resynchronisation therapy selection.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Chronic heart failure (CHF) often coexists with left bundle branch block (LBBB) on ECG.
  • LBBB significantly alters ventricular depolarization, impacting cardiac function and response to therapies.
  • Accurate assessment of left ventricular (LV) activation is essential for optimizing treatment strategies.

Purpose of the Study:

  • To elucidate the specific patterns of LV endocardial activation in patients diagnosed with CHF and LBBB.
  • To investigate the variability of LV activation sequences in this patient cohort.

Main Methods:

  • A prospective study involving seven patients with reduced LV ejection fraction (<35%) and typical LBBB (QRS duration ≥130 ms).
  • Utilized non-contact mapping to determine global LV activation sequences.

Related Experiment Videos

  • Correlated Tissue Doppler imaging findings with non-contact mapping data to identify conduction blocks and latest activation sites.

    • Main Results:

    • Observed significant variability in LV activation patterns, with some patients showing preserved left bundle activation despite LBBB.
    • Identified conduction blocks during LV activation in four patients and homogeneous depolarization in three.
    • Latest activation segments were consistently located in the LV lateral or posterior regions.
    • Tissue Doppler imaging demonstrated good correlation with non-contact mapping for localization.

    Conclusions:

    • LV endocardial activation sequences in patients with CHF and LBBB are highly variable.
    • These findings highlight the complexity of LV activation in LBBB and have direct implications for patient selection for cardiac resynchronisation therapy (CRT).