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Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria
Background Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). CRT efficacy is greater in left bundle branch block (LBBB). This study aimed to determine if strict LBBB criteria predict an improved QRS duration and left vent...
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| Published in: | Pacing and clinical electrophysiology 2019-04, Vol.42 (4), p.431-438 |
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| cites | cdi_FETCH-LOGICAL-c3578-7569d1e2653b4093d09cfe1f57991f255de0c61dc75f4804535b8709d2b67d513 |
| container_end_page | 438 |
| container_issue | 4 |
| container_start_page | 431 |
| container_title | Pacing and clinical electrophysiology |
| container_volume | 42 |
| creator | Hadjis, Alexios AlTurki, Ahmed Proietti, Riccardo Montemezzo, Mauricio Bernier, Martin Joza, Jacqueline Hadjis, Tomy Essebag, Vidal |
| description | Background
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). CRT efficacy is greater in left bundle branch block (LBBB). This study aimed to determine if strict LBBB criteria predict an improved QRS duration and left ventricular ejection fraction (LVEF) response after CRT.
Methods
HFrEF patients who received a CRT device at a single quaternary center were included. Patients were divided into three groups based on baseline QRS morphology. Group 1 consisted of patients with strict LBBB. Group 2 had conventional LBBB, and group 3 had non‐LBBB morphology. Outcomes assessed included change in QRS duration after CRT, change in LVEF, and all‐cause mortality.
Results
In 231 patients, 56% of patients were in group 1, 29% were in group 2, and 15% were in group 3. Patients with strict LBBB had a significant reduction in QRS duration (–20.9 ± 12.4 ms) compared to conventional LBBB (6.7 ± 19.4 ms; P |
| doi_str_mv | 10.1111/pace.13638 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2183641420</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2200608575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3578-7569d1e2653b4093d09cfe1f57991f255de0c61dc75f4804535b8709d2b67d513</originalsourceid><addsrcrecordid>eNp9kUFP3DAQhS1U1F2WXvoDkKVeqkoBO45jm9tqtaVISHCAs-XYEzDNxsFOhJZfXy9LOXBgLiONvnmaeQ-h75Sc0lxng7FwSlnN5AGaU16RQlKuvqA5oZUoJJNqho5SeiSE1KTiX9GMESEUFWKO_E0E5-3o-3scIQ2hT4DHgK2Jzhu7m217-xBD71_M6EOPxweIZtie47tMhhanMeZ93EE74mbqXQe4iSbv4KYL9i-20Y8QvTlGh63pEnx76wt093t9u_pTXF1fXK6WV4VlXMhC8Fo5CmXNWVMRxRxRtgXacqEUbUvOHRBbU2cFbyuZ32G8kYIoVza1cJyyBfq51x1ieJogjXrjk4WuMz2EKemSSlZXtCpJRn98QB_DFPt8nS7LnVmSC56pX3vKxpBShFYP0W9M3GpK9C4AvQtAvwaQ4ZM3yanZgHtH_zueAboHnn0H20-k9M1ytd6L_gMbWZAA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2200608575</pqid></control><display><type>article</type><title>Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria</title><source>Wiley</source><source>SPORTDiscus</source><creator>Hadjis, Alexios ; AlTurki, Ahmed ; Proietti, Riccardo ; Montemezzo, Mauricio ; Bernier, Martin ; Joza, Jacqueline ; Hadjis, Tomy ; Essebag, Vidal</creator><creatorcontrib>Hadjis, Alexios ; AlTurki, Ahmed ; Proietti, Riccardo ; Montemezzo, Mauricio ; Bernier, Martin ; Joza, Jacqueline ; Hadjis, Tomy ; Essebag, Vidal</creatorcontrib><description>Background
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). CRT efficacy is greater in left bundle branch block (LBBB). This study aimed to determine if strict LBBB criteria predict an improved QRS duration and left ventricular ejection fraction (LVEF) response after CRT.
Methods
HFrEF patients who received a CRT device at a single quaternary center were included. Patients were divided into three groups based on baseline QRS morphology. Group 1 consisted of patients with strict LBBB. Group 2 had conventional LBBB, and group 3 had non‐LBBB morphology. Outcomes assessed included change in QRS duration after CRT, change in LVEF, and all‐cause mortality.
Results
In 231 patients, 56% of patients were in group 1, 29% were in group 2, and 15% were in group 3. Patients with strict LBBB had a significant reduction in QRS duration (–20.9 ± 12.4 ms) compared to conventional LBBB (6.7 ± 19.4 ms; P < 0.0001) and non‐LBBB (3.9 ± 29.3 ms; P < 0.0001). Patients with strict LBBB had a significant increase in LVEF (19.5 ± 10.2) compared to conventional LBBB (5.3 ± 12.6; P < 0.0001) and non‐LBBB (–1.3 ± 10.9; P < 0.0001). There was moderate negative correlation between changes in QRS duration and LVEF (correlation coefficient = –0.63, P < 0.0001). Strict LBBB criteria were associated with a significant reduction in mortality compared to conventional LBBB (odds ratio 0.49, 95% confidence interval 0.24 to 0.99; P = 0.046).
Conclusions
Strict LBBB predicted a reduction in QRS duration and an increase in LVEF compared to conventional LBBB and non‐LBBB morphology in patients with HFrEF who received CRT.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13638</identifier><identifier>PMID: 30779177</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Bundle-Branch Block - physiopathology ; Cardiac Resynchronization Therapy ; Congestive heart failure ; Electrocardiography ; Female ; Heart Failure - physiopathology ; Heart Failure - therapy ; Humans ; left bundle branch block ; Male ; Morbidity ; Morphology ; Mortality ; QRS duration ; Stroke Volume ; Ventricle ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - therapy</subject><ispartof>Pacing and clinical electrophysiology, 2019-04, Vol.42 (4), p.431-438</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-7569d1e2653b4093d09cfe1f57991f255de0c61dc75f4804535b8709d2b67d513</citedby><cites>FETCH-LOGICAL-c3578-7569d1e2653b4093d09cfe1f57991f255de0c61dc75f4804535b8709d2b67d513</cites><orcidid>0000-0003-0593-9191 ; 0000-0003-4113-7030</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30779177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hadjis, Alexios</creatorcontrib><creatorcontrib>AlTurki, Ahmed</creatorcontrib><creatorcontrib>Proietti, Riccardo</creatorcontrib><creatorcontrib>Montemezzo, Mauricio</creatorcontrib><creatorcontrib>Bernier, Martin</creatorcontrib><creatorcontrib>Joza, Jacqueline</creatorcontrib><creatorcontrib>Hadjis, Tomy</creatorcontrib><creatorcontrib>Essebag, Vidal</creatorcontrib><title>Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Background
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). CRT efficacy is greater in left bundle branch block (LBBB). This study aimed to determine if strict LBBB criteria predict an improved QRS duration and left ventricular ejection fraction (LVEF) response after CRT.
Methods
HFrEF patients who received a CRT device at a single quaternary center were included. Patients were divided into three groups based on baseline QRS morphology. Group 1 consisted of patients with strict LBBB. Group 2 had conventional LBBB, and group 3 had non‐LBBB morphology. Outcomes assessed included change in QRS duration after CRT, change in LVEF, and all‐cause mortality.
Results
In 231 patients, 56% of patients were in group 1, 29% were in group 2, and 15% were in group 3. Patients with strict LBBB had a significant reduction in QRS duration (–20.9 ± 12.4 ms) compared to conventional LBBB (6.7 ± 19.4 ms; P < 0.0001) and non‐LBBB (3.9 ± 29.3 ms; P < 0.0001). Patients with strict LBBB had a significant increase in LVEF (19.5 ± 10.2) compared to conventional LBBB (5.3 ± 12.6; P < 0.0001) and non‐LBBB (–1.3 ± 10.9; P < 0.0001). There was moderate negative correlation between changes in QRS duration and LVEF (correlation coefficient = –0.63, P < 0.0001). Strict LBBB criteria were associated with a significant reduction in mortality compared to conventional LBBB (odds ratio 0.49, 95% confidence interval 0.24 to 0.99; P = 0.046).
Conclusions
Strict LBBB predicted a reduction in QRS duration and an increase in LVEF compared to conventional LBBB and non‐LBBB morphology in patients with HFrEF who received CRT.</description><subject>Aged</subject><subject>Bundle-Branch Block - physiopathology</subject><subject>Cardiac Resynchronization Therapy</subject><subject>Congestive heart failure</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>left bundle branch block</subject><subject>Male</subject><subject>Morbidity</subject><subject>Morphology</subject><subject>Mortality</subject><subject>QRS duration</subject><subject>Stroke Volume</subject><subject>Ventricle</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - therapy</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kUFP3DAQhS1U1F2WXvoDkKVeqkoBO45jm9tqtaVISHCAs-XYEzDNxsFOhJZfXy9LOXBgLiONvnmaeQ-h75Sc0lxng7FwSlnN5AGaU16RQlKuvqA5oZUoJJNqho5SeiSE1KTiX9GMESEUFWKO_E0E5-3o-3scIQ2hT4DHgK2Jzhu7m217-xBD71_M6EOPxweIZtie47tMhhanMeZ93EE74mbqXQe4iSbv4KYL9i-20Y8QvTlGh63pEnx76wt093t9u_pTXF1fXK6WV4VlXMhC8Fo5CmXNWVMRxRxRtgXacqEUbUvOHRBbU2cFbyuZ32G8kYIoVza1cJyyBfq51x1ieJogjXrjk4WuMz2EKemSSlZXtCpJRn98QB_DFPt8nS7LnVmSC56pX3vKxpBShFYP0W9M3GpK9C4AvQtAvwaQ4ZM3yanZgHtH_zueAboHnn0H20-k9M1ytd6L_gMbWZAA</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Hadjis, Alexios</creator><creator>AlTurki, Ahmed</creator><creator>Proietti, Riccardo</creator><creator>Montemezzo, Mauricio</creator><creator>Bernier, Martin</creator><creator>Joza, Jacqueline</creator><creator>Hadjis, Tomy</creator><creator>Essebag, Vidal</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0593-9191</orcidid><orcidid>https://orcid.org/0000-0003-4113-7030</orcidid></search><sort><creationdate>201904</creationdate><title>Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria</title><author>Hadjis, Alexios ; AlTurki, Ahmed ; Proietti, Riccardo ; Montemezzo, Mauricio ; Bernier, Martin ; Joza, Jacqueline ; Hadjis, Tomy ; Essebag, Vidal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-7569d1e2653b4093d09cfe1f57991f255de0c61dc75f4804535b8709d2b67d513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Bundle-Branch Block - physiopathology</topic><topic>Cardiac Resynchronization Therapy</topic><topic>Congestive heart failure</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>left bundle branch block</topic><topic>Male</topic><topic>Morbidity</topic><topic>Morphology</topic><topic>Mortality</topic><topic>QRS duration</topic><topic>Stroke Volume</topic><topic>Ventricle</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hadjis, Alexios</creatorcontrib><creatorcontrib>AlTurki, Ahmed</creatorcontrib><creatorcontrib>Proietti, Riccardo</creatorcontrib><creatorcontrib>Montemezzo, Mauricio</creatorcontrib><creatorcontrib>Bernier, Martin</creatorcontrib><creatorcontrib>Joza, Jacqueline</creatorcontrib><creatorcontrib>Hadjis, Tomy</creatorcontrib><creatorcontrib>Essebag, Vidal</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hadjis, Alexios</au><au>AlTurki, Ahmed</au><au>Proietti, Riccardo</au><au>Montemezzo, Mauricio</au><au>Bernier, Martin</au><au>Joza, Jacqueline</au><au>Hadjis, Tomy</au><au>Essebag, Vidal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2019-04</date><risdate>2019</risdate><volume>42</volume><issue>4</issue><spage>431</spage><epage>438</epage><pages>431-438</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Background
Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). CRT efficacy is greater in left bundle branch block (LBBB). This study aimed to determine if strict LBBB criteria predict an improved QRS duration and left ventricular ejection fraction (LVEF) response after CRT.
Methods
HFrEF patients who received a CRT device at a single quaternary center were included. Patients were divided into three groups based on baseline QRS morphology. Group 1 consisted of patients with strict LBBB. Group 2 had conventional LBBB, and group 3 had non‐LBBB morphology. Outcomes assessed included change in QRS duration after CRT, change in LVEF, and all‐cause mortality.
Results
In 231 patients, 56% of patients were in group 1, 29% were in group 2, and 15% were in group 3. Patients with strict LBBB had a significant reduction in QRS duration (–20.9 ± 12.4 ms) compared to conventional LBBB (6.7 ± 19.4 ms; P < 0.0001) and non‐LBBB (3.9 ± 29.3 ms; P < 0.0001). Patients with strict LBBB had a significant increase in LVEF (19.5 ± 10.2) compared to conventional LBBB (5.3 ± 12.6; P < 0.0001) and non‐LBBB (–1.3 ± 10.9; P < 0.0001). There was moderate negative correlation between changes in QRS duration and LVEF (correlation coefficient = –0.63, P < 0.0001). Strict LBBB criteria were associated with a significant reduction in mortality compared to conventional LBBB (odds ratio 0.49, 95% confidence interval 0.24 to 0.99; P = 0.046).
Conclusions
Strict LBBB predicted a reduction in QRS duration and an increase in LVEF compared to conventional LBBB and non‐LBBB morphology in patients with HFrEF who received CRT.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30779177</pmid><doi>10.1111/pace.13638</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0593-9191</orcidid><orcidid>https://orcid.org/0000-0003-4113-7030</orcidid></addata></record> |
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| ispartof | Pacing and clinical electrophysiology, 2019-04, Vol.42 (4), p.431-438 |
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| source | Wiley; SPORTDiscus |
| subjects | Aged Bundle-Branch Block - physiopathology Cardiac Resynchronization Therapy Congestive heart failure Electrocardiography Female Heart Failure - physiopathology Heart Failure - therapy Humans left bundle branch block Male Morbidity Morphology Mortality QRS duration Stroke Volume Ventricle Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - therapy |
| title | Predicting response to cardiac resynchronization therapy: Use of strict left bundle branch block criteria |
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