Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block.
Cardiac resynchronization therapy
Cardiomyopathies
Right bundle branch block
Journal
The journal of Tehran Heart Center
ISSN: 1735-5370
Titre abrégé: J Tehran Heart Cent
Pays: Iran
ID NLM: 101289255
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
22
08
2022
accepted:
14
12
2023
medline:
28
8
2023
pubmed:
28
8
2023
entrez:
28
8
2023
Statut:
ppublish
Résumé
The use of cardiac resynchronization therapy (CRT) in heart failure patients with right bundle branch block (RBBB) is under debate. We present early and late echocardiographic characteristics of a series of heart failure patients with RBBB who underwent CRT. In this retrospective descriptive study, 18 patients with RBBB in the surface electrocardiogram underwent CRT between 2005 and 2015. All the patients had the New York Heart Association functional class III/IV, a left ventricular ejection fraction (LVEF) ≤35%, and a QRS duration ≥120 milliseconds. The median follow-up duration was 19 months. The echocardiographic response was based on a ≥5% increase in LVEF. Within 48 hours after CRT implantation, LVEF increased from 24.58%±7.08% before to 28.46±8.91% after CRT (P=0.005) and to 30.00±9.44% at follow-up (P=0.008). Among the 18 patients, 12 (66.7%) were responders within 48 hours after CRT. The following baseline echocardiographic parameters were higher in the responders than in those without an increased LVEF, although the difference did not reach statistical significance: septal-to-lateral wall delay (48.33±33.53 vs 43.33±38.82 ms), anteroseptal-to-posterior wall delay (41.7±1.75 vs 38.33±18.35 ms), and interventricular mechanical delay (48.50±21.13 vs 31.17±19.93 ms). The mean QRS duration was higher in the responders than in the non-responders (183.58±40.69 vs 169.00±27.36 ms). Death was reported in 3 out of the 18 patients (16.7%) at follow-up. The 3 deceased patients had a higher baseline interventricular mechanical delay than those who survived. Our results indicated that patients with RBBB might benefit from CRT. Further, patients with higher intra and interventricular dyssynchrony and a wider QRS may show better responses.
Sections du résumé
Background
UNASSIGNED
The use of cardiac resynchronization therapy (CRT) in heart failure patients with right bundle branch block (RBBB) is under debate. We present early and late echocardiographic characteristics of a series of heart failure patients with RBBB who underwent CRT.
Methods
UNASSIGNED
In this retrospective descriptive study, 18 patients with RBBB in the surface electrocardiogram underwent CRT between 2005 and 2015. All the patients had the New York Heart Association functional class III/IV, a left ventricular ejection fraction (LVEF) ≤35%, and a QRS duration ≥120 milliseconds. The median follow-up duration was 19 months. The echocardiographic response was based on a ≥5% increase in LVEF.
Results
UNASSIGNED
Within 48 hours after CRT implantation, LVEF increased from 24.58%±7.08% before to 28.46±8.91% after CRT (P=0.005) and to 30.00±9.44% at follow-up (P=0.008). Among the 18 patients, 12 (66.7%) were responders within 48 hours after CRT. The following baseline echocardiographic parameters were higher in the responders than in those without an increased LVEF, although the difference did not reach statistical significance: septal-to-lateral wall delay (48.33±33.53 vs 43.33±38.82 ms), anteroseptal-to-posterior wall delay (41.7±1.75 vs 38.33±18.35 ms), and interventricular mechanical delay (48.50±21.13 vs 31.17±19.93 ms). The mean QRS duration was higher in the responders than in the non-responders (183.58±40.69 vs 169.00±27.36 ms). Death was reported in 3 out of the 18 patients (16.7%) at follow-up. The 3 deceased patients had a higher baseline interventricular mechanical delay than those who survived.
Conclusion
UNASSIGNED
Our results indicated that patients with RBBB might benefit from CRT. Further, patients with higher intra and interventricular dyssynchrony and a wider QRS may show better responses.
Identifiants
pubmed: 37637276
doi: 10.18502/jthc.v18i2.13320
pii: JTHC-18-109
pmc: PMC10459338
doi:
Types de publication
Journal Article
Langues
eng
Pagination
109-114Informations de copyright
Copyright© 2023 Tehran University of Medical Sciences.
Références
Eur Heart J. 2013 Aug;34(29):2281-329
pubmed: 23801822
Heart Rhythm. 2009 Oct;6(10):1439-47
pubmed: 19717348
J Am Soc Echocardiogr. 2008 Mar;21(3):191-213
pubmed: 18314047
Circulation. 2012 Oct 2;126(14):1784-800
pubmed: 22965336
Am J Cardiol. 2001 Dec 15;88(12):1436-41, A8
pubmed: 11741571
Am J Cardiol. 2009 Jan 15;103(2):238-42
pubmed: 19121443
Circ Arrhythm Electrophysiol. 2014 Jun;7(3):543-52
pubmed: 24951572
Circulation. 2010 Nov 16;122(20):2022-30
pubmed: 21041691
J Tehran Heart Cent. 2013 Apr;8(2):95-100
pubmed: 23967031
Circ Arrhythm Electrophysiol. 2014 Jun;7(3):532-42
pubmed: 24951571
Echocardiography. 2012;29(1):7-12
pubmed: 22050328
Eur Heart J. 2012 Nov;33(21):2680-91
pubmed: 22351700
N Engl J Med. 2010 Dec 16;363(25):2385-95
pubmed: 21073365