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 retros...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2023-04-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/1707 |
| _version_ | 1797742501414567936 |
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| author | Sara Zand Hakimeh Sadeghian Ali Kazemisaid Masoumeh Lotfi-Tokaldany Arash Jalali Akram Sardari |
| author_facet | Sara Zand Hakimeh Sadeghian Ali Kazemisaid Masoumeh Lotfi-Tokaldany Arash Jalali Akram Sardari |
| author_sort | Sara Zand |
| collection | DOAJ |
| 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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| first_indexed | 2024-03-12T14:41:43Z |
| format | Article |
| id | doaj.art-182d9ac1e56f4f34a4221001c35218b1 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-03-12T14:41:43Z |
| publishDate | 2023-04-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-182d9ac1e56f4f34a4221001c35218b12023-08-16T06:22:47ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712023-04-0118210.18502/jthc.v18i2.13320Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch BlockSara Zand0Hakimeh Sadeghian1Ali Kazemisaid2Masoumeh Lotfi-Tokaldany3Arash Jalali4Akram Sardari51- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IranTehran University of Medical Sciences, Tehran, Iran.3- Electrophysiology department, Sina Hospital, Tehran University of Medical Science, Tehran, Iran4- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran4- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, IranDepartment of Cardiology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 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. https://jthc.tums.ac.ir/index.php/jthc/article/view/1707Cardiac resynchronization therapyRight bundle branch blockCardiomyopathies |
| spellingShingle | Sara Zand Hakimeh Sadeghian Ali Kazemisaid Masoumeh Lotfi-Tokaldany Arash Jalali Akram Sardari Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block Journal of Tehran University Heart Center Cardiac resynchronization therapy Right bundle branch block Cardiomyopathies |
| 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 | Cardiac resynchronization therapy Right bundle branch block Cardiomyopathies |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/1707 |
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