Predictors of long-term benefit of cardiac resynchronization therapy in patients with right bundle branch block.
نویسندگان
چکیده
AIMS The aims of this study were: (i) to characterize consecutive cardiac resynchronization therapy (CRT) recipients with right bundle branch block (RBBB) in comparison with left bundle branch block (LBBB) and (ii) to identify independent predictors of long-term outcome among CRT recipients with RBBB. The presence of RBBB has been associated with poorer prognosis after CRT compared with LBBB; however, little is known about the differences in cardiac mechanics between RBBB and LBBB patients. Furthermore, predictors of favourable outcome after CRT in patients with RBBB have not been identified. METHODS AND RESULTS Five hundred and sixty-one consecutive CRT recipients (89 with RBBB and 472 with LBBB) underwent echocardiography before and 6 months after CRT to determine left ventricular (LV) size and function, and interventricular and LV dyssynchrony (as measured by tissue Doppler imaging). Long-term follow-up to identify a composite endpoint of all-cause mortality or heart failure hospitalization was available. Right bundle branch block patients exhibited a higher prevalence of male gender, ischaemic heart disease, atrial fibrillation, and lower exercise capacity when compared with LBBB patients, despite smaller LV volumes. In addition, the extent of both interventricular and LV dyssynchrony was less in RBBB patients. Six months after CRT, RBBB patients also showed limited LV reverse remodelling. At long-term follow-up, LV dyssynchrony and mitral regurgitation were identified as independent predictors of all-cause mortality or heart failure hospitalization among RBBB patients. CONCLUSION Left ventricular dyssynchrony may be an important determinant of outcome following CRT in patients with RBBB and may help in the selection of CRT candidates.
منابع مشابه
Does cardiac resynchronization therapy benefit patients with right bundle branch block: left ventricular free wall pacing: seldom right for right bundle branch block.
متن کامل
Does cardiac resynchronization therapy benefit patients with right bundle branch block: cardiac resynchronization therapy has a role in patients with right bundle branch block.
Branch Block Block: Cardiac Resynchronization Therapy Has a Role in Patients With Right Bundle Does Cardiac Resynchronization Therapy Benefit Patients With Right Bundle Branch Print ISSN: 1941-3149. Online ISSN: 1941-3084 Copyright © 2014 American Heart Association, Inc. All rights reserved. Avenue, Dallas, TX 75231 is published by the American Heart Association, 7272 Greenville Circulation: Ar...
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ورودعنوان ژورنال:
- European heart journal
دوره 33 15 شماره
صفحات -
تاریخ انتشار 2012