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Updated: Feb 10, 2026

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

11.0K

Comparison of four LBBB definitions for predicting mortality in patients receiving cardiac resynchronization therapy

Marek Jastrzębski1, Piotr Kukla2, Roksana Kisiel1

  • 1First Department of Cardiology, Interventional Electrocardiology and Hypertension, Medical College, Jagiellonian University, Cracow, Poland.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|May 29, 2018
PubMed

Insights

The Strauss definition of Left Bundle Branch Block (LBBB) best predicts survival in cardiac resynchronization therapy (CRT) patients. Different LBBB criteria impact mortality benefits from CRT.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Left bundle branch block (LBBB) is a key prognostic indicator for cardiac resynchronization therapy (CRT).
  • Evaluating long-term outcomes based on various LBBB definitions in CRT patients is crucial.

Purpose of the Study:

  • To compare the long-term prognostic value of four distinct electrocardiographic definitions of LBBB in patients undergoing CRT.
  • To determine which LBBB definition best predicts mortality and morbidity in this cohort.

Main Methods:

  • A longitudinal cohort study of 552 patients who received CRT between 2006-2014.
  • Pre-implantation ECGs were analyzed by blinded physicians using four different LBBB definitions.
  • Outcomes assessed included all-cause mortality, urgent heart transplantation, and heart failure admissions over a 9-year follow-up.

Main Results:

  • The Strauss definition identified LBBB in 40.9% of patients, differing from conventional (63.4%) and other definitions.
  • The Strauss LBBB definition demonstrated superior predictive accuracy for survival compared to other definitions.
  • Multivariate analysis indicated LBBB as a major mortality determinant, with the Strauss definition showing the lowest hazard ratio (0.51).

Conclusions:

  • Electrocardiographic definitions of LBBB identify distinct patient groups.
  • The choice of LBBB definition has significant clinical implications for predicting CRT outcomes.
  • Patients lacking 'complete/true' LBBB by specific criteria may not benefit from CRT regarding mortality.
Abstract

Keywords:
Left bundle branch blockcardiac resynchronization therapycomplete blockcriteriamortality

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