Cardiac resynchronisation therapy in patients with left bundle branch block with residual conduction.
Cardiac resynchronisation therapy
Heart failure
Left bundle branch block
Left bundle branch block with residual conduction
Journal
Indian pacing and electrophysiology journal
ISSN: 0972-6292
Titre abrégé: Indian Pacing Electrophysiol J
Pays: Netherlands
ID NLM: 101157207
Informations de publication
Date de publication:
Historique:
received:
03
06
2020
revised:
29
10
2020
accepted:
31
10
2020
pubmed:
20
11
2020
medline:
20
11
2020
entrez:
19
11
2020
Statut:
ppublish
Résumé
To evaluate whether left bundle branch block with residual conduction (rLBBB) is associated with worse outcomes after cardiac resynchronisation therapy (CRT). All consecutive CRT implants at our institution between 2006 and 2013 were identified from our local device registry. Pre- and post-implant patient specific data were extracted from clinical records. A total of 690 CRT implants were identified during the study period. Prior to CRT, 52.2% of patients had true left bundle branch block (LBBB), 19.1% a pacing-induced LBBB (pLBBB), 11.2% a rLBBB, 0.8% a right bundle branch block (RBBB), and 16.5% had a nonspecific intraventricular conduction delay (IVCD) electrocardiogram pattern. Mean age at implant was 67.5 years (standard deviation [SD] = 10.6), mean left ventricular ejection fraction (LV EF) was 25.7% (SD = 7.9%), and mean QRS duration was 158.4 ms (SD = 32 ms). After CRT, QRS duration was significantly reduced in the LBBB (p < 0.001), pLBBB (p < 0.001), rLBBB (p < 0.001), RBBB (p = 0.04), and IVCD groups (p = 0.03). LV EF significantly improved in the LBBB (p < 0.001), rLBBB (p = 0.002), and pLBBB (p < 0.001) groups, but the RBBB and IVCD groups showed no improvement. There was no significant difference in mortality between the LBBB and rLBBB groups. LV EF post-CRT, chronic kidney disease, hyperkalaemia, hypernatremia, and age at implant were significant predictors of mortality. CRT in patients with rLBBB results in improved LV EF and similar mortality rates to CRT patients with complete LBBB. Predictors of mortality post-CRT include post-CRT LV EF, presence of CKD, hyperkalaemia, hypernatremia, and older age at implant.
Identifiants
pubmed: 33212244
pii: S0972-6292(20)30133-9
doi: 10.1016/j.ipej.2020.10.006
pmc: PMC7854372
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
14-17Informations de copyright
Copyright © 2020 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.
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