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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

Ventricular dyssynchrony patterns in left bundle branch block, with and without heart failure

Hygriv B Rao1, Raghu Krishnaswami, Sharada Kalavakolanu

  • 1CARE Hospital, Institute of Medical Sciences, Hyderabad, India. hygriv@hotmail.com

Indian Pacing and Electrophysiology Journal
|March 18, 2010
PubMed

Insights

Heart failure patients with LBBB often show dyssynchrony, impacting cardiac resynchronization therapy selection. Lateral wall delays are common in heart failure, unlike in normal LBBB hearts.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Management

Background:

  • Ventricular dyssynchrony assessment is crucial for cardiac resynchronization therapy (CRT) candidate selection.
  • Regional dyssynchrony patterns in heart failure (HF) with left bundle branch block (LBBB) are not well-defined.

Purpose of the Study:

  • To delineate regional dyssynchrony patterns in patients with LBBB, with and without heart failure.

Main Methods:

  • Tissue Doppler Imaging (TDI) analyzed velocity curves from septal and lateral walls.
  • Interventricular dyssynchrony (IVD) and left ventricular dyssynchrony (LVD) assessed by timing differences.
  • A delay of ≥40 msec defined significant dyssynchrony.

Main Results:

  • 72% of HF patients with LBBB exhibited dyssynchrony versus 16% in controls (P<0.01).
  • Lateral wall dyssynchrony was prevalent in HF (37%) but absent in controls (P<0.01).
  • Septal dyssynchrony was similar between groups (16%, P=NS).

Conclusions:

  • Significant dyssynchrony is common in HF patients with LBBB, with heterogeneous regional distribution.
  • Dyssynchrony can occur in LBBB without HF, but typically spares the lateral wall.
  • Lateral wall delay may be a more specific indicator of dyssynchrony in HF patients.
Abstract

Keywords:
DyssynchronyHeart FailureLBBBNormal HeartTissue Doppler Imaging

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