Document Detail

A left hemiblock improves cardiac resynchronization therapy outcomes in patients with a right bundle branch block.
MedLine Citation:
PMID:  20186989     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The current recommendation for cardiac resynchronization therapy (CRT) in congestive heart failure (CHF) patients is based on QRS duration, not on QRS morphology. HYPOTHESIS: This study was performed to compare the effects of CRT in CHF patients with pure RBBB vs those with a coexisting left hemiblock (LHB). METHODS AND PATIENT POPULATION: A total of 271 consecutive patients who underwent CRT at Montefiore Medical Center were analyzed. Baseline ECGs were analyzed by 2 reviewers for RBBB and further classified into those with a coexisting LHB. Response to CRT was defined to be, at > or = 6 months after CRT, either an improvement in ejection fraction (EF) of at least 5%, or an improvement in New York Heart Association (NYHA) CHF class. A total of 44 patients were identified: 18 had pure RBBB and 26 had a coexisting LHB. The 2 groups were similar in respect to baseline characteristics (P > 0.05). RESULTS: Only 4 out of 18 patients with pure RBBB compared to 18 out of 26 with LHB (P = 0.005) had an improvement in EF > or = 5%. The mean EF was - 1% in the pure RBBB group, but + 5.4% in those with LHB (P = 0.0031). Improvement in NYHA class was seen in 0 out of 18 with pure RBBB vs 7 out of 26 patients with LHB (P = 0.03). CONCLUSION: If patients with RBBB also had LHB, their response to CRT was significantly better than if they had RBBB alone.
Ramesh Chandra; Ronald Zolty; Eugen Palma
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-93     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley Periodicals, Inc.
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA.
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MeSH Terms
Bundle-Branch Block / diagnosis,  physiopathology,  therapy*
Cardiac Pacing, Artificial*
Chi-Square Distribution
Heart Failure / diagnosis,  physiopathology,  therapy*
Recovery of Function
Retrospective Studies
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left

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