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Electrocardiographic Criteria of True Left Bundle Branch Block: A Simple Sign to Predict a Better Clinical and Instrumental Response to CRT.
MedLine Citation:
PMID:  22651702     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Cardiac resynchronization therapy (CRT) has proved to be very effective in improving morbidity and mortality in patients affected with severe congestive heart failure. Its efficacy has been shown to be greater in patients with left bundle branch block (LBBB). The aim of our study was to verify if newly proposed criteria for true LBBB identify patients with a better clinical and instrumental response to CRT. Methods: Between May 2007 and April 2011, 111 patients with left ventricular ejection fraction (LVEF) ≤ 35% and LBBB morphology received a CRT device and were divided into two groups according to QRS morphology. Group 1 (61 patients) consisted of patients with "true" LBBB morphology; group 2 (50 patients) consisted of patients with "false" LBBB. The primary endpoint was the utility of criteria for true LBBB to predict a composite endpoint of all-cause mortality and hospital admission with heart failure. The secondary endpoint was the utility of the same criteria to predict an absolute increase in LVEF ≥ 10%. Results: "False" LBBB morphology and a dose of bisoprolol <5 mg at last follow-up were the only parameters related to clinical outcome in multivariate analysis (respectively: hazard ratio [HR] 3.98, confidence interval [CI] 95% 1.51-10.48; HR 0.15, CI 95% 0.05-0.43). "True" LBBB morphology was the only variable significantly related to a greater increase in LVEF (HR 4.57, CI 95% 1.36-8.28). Conclusion: True LBBB morphology is related to a higher event-free survival rate in CRT patients and better echocardiographic response. (PACE 2012;XX:1-8).
Authors:
Giosuè Mascioli; Luigi Padeletti; Biagio Sassone; Massimo Zecchin; Elena Lucca; Stefania Sacchi; Giulio Boggian; Anna Ludovica Tondo; Chiara Belvito; Nikoloz Bakhtadze; Alessio Borrelli; Gianfranco Sinagra
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-31
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  -     ISSN:  1540-8159     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-6-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Affiliation:
Department of Arrhythmology, Cliniche Humanitas Gavazzeni, Bergamo, Italy Institute of Internal Medicine and Cardiology, University of Florence, Ospedale di Careggi, Florence, Italy Department of Cardiology, Ospedale Bentivoglio, Bologna, Italy Department of Cardiology, Ospedali Riuniti, Trieste, Italy.
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