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Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block

BACKGROUND: 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: In this retrospectiv...

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Autores principales: Zand, Sara, Sadeghian, Hakimeh, Kazemisaid, Ali, Lotfi-Tokaldany, Masoumeh, Jalali, Arash, Sardari, Akram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10459338/
https://www.ncbi.nlm.nih.gov/pubmed/37637276
http://dx.doi.org/10.18502/jthc.v18i2.13320
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author Zand, Sara
Sadeghian, Hakimeh
Kazemisaid, Ali
Lotfi-Tokaldany, Masoumeh
Jalali, Arash
Sardari, Akram
author_facet Zand, Sara
Sadeghian, Hakimeh
Kazemisaid, Ali
Lotfi-Tokaldany, Masoumeh
Jalali, Arash
Sardari, Akram
author_sort Zand, Sara
collection PubMed
description BACKGROUND: 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: 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: 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: 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.
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spelling pubmed-104593382023-08-27 Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block Zand, Sara Sadeghian, Hakimeh Kazemisaid, Ali Lotfi-Tokaldany, Masoumeh Jalali, Arash Sardari, Akram J Tehran Heart Cent Original Article BACKGROUND: 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: 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: 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: 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. Tehran University of Medical Sciences 2023-04 /pmc/articles/PMC10459338/ /pubmed/37637276 http://dx.doi.org/10.18502/jthc.v18i2.13320 Text en Copyright© 2023 Tehran University of Medical Sciences https://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org/licenses/by-nc/4.0/). Noncommercial uses of the work are permitted, provided the original work is properly cited.
spellingShingle Original Article
Zand, Sara
Sadeghian, Hakimeh
Kazemisaid, Ali
Lotfi-Tokaldany, Masoumeh
Jalali, Arash
Sardari, Akram
Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title_full Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title_fullStr Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title_full_unstemmed Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title_short Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
title_sort response to cardiac resynchronization therapy in cardiomyopathy patients with right bundle branch block
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10459338/
https://www.ncbi.nlm.nih.gov/pubmed/37637276
http://dx.doi.org/10.18502/jthc.v18i2.13320
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