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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Electrical remodeling and cardiac dimensions in patients treated by cardiac resynchronization and heart failure

Martin Stockburger1, Aischa Nitardy, Suzanne Fateh-Moghadam

  • 1Charité-Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Medizinische Klinik mit Schwerpunkt Kardiologie, Berlin, Germany. martin.stockburger@charite.de

Pacing and Clinical Electrophysiology : PACE
|January 10, 2008
PubMed

Insights

Cardiac resynchronization therapy (CRT) reduces left ventricular diameter and mitral regurgitation in heart failure patients with left bundle branch block (LBBB). However, electrical remodeling does not differ from controls without CRT.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Cardiac resynchronization therapy (CRT) is known to reduce left ventricular diameter (LVEDD) in heart failure (HF) patients with left bundle branch block (LBBB).
  • This study investigates and compares structural and electrical remodeling in HF patients undergoing CRT versus matched HF controls without LBBB.

Purpose of the Study:

  • To compare the effects of CRT on structural and electrical remodeling in heart failure patients with LBBB.
  • To assess changes in left ventricular diameter, atrial width, mitral regurgitation, and various electrocardiogram parameters.

Main Methods:

  • 42 patients (21 with LBBB indicated for CRT, 21 matched controls without LBBB) underwent ECG and echocardiogram at baseline and follow-up (20.6 months).
  • Analyzed parameters included LVEDD, left atrial width, mitral regurgitation, P-wave, PR interval, QRS width, QRS vector, and QT interval.

Main Results:

  • CRT significantly reduced LVEDD (P=0.002) and improved mitral regurgitation (P=0.02).
  • No significant changes in LVEDD or mitral regurgitation were observed in controls.
  • PR interval lengthened in both groups, and QRS duration increased in controls (P=0.01).

Conclusions:

  • CRT effectively reduces LVEDD and improves mitral regurgitation in HF patients with LBBB.
  • Despite structural improvements, CRT does not lead to recovery of electrical activation.
  • Electrical remodeling patterns are similar between LBBB patients on CRT and matched controls without CRT.
Abstract

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