9/12/2023 0 Comments Sinus rhythm with ivcd meaning![]() ![]() 8–10 Thus, identification of the precise LBBB configuration that is associated with maximally effective CRT is important. However, about 30% of patients still obtain little or no benefit from CRT, including some with LBBB morphology. 3–5 On the basis of these findings, the most recently published European 6 and US 7 guidelines, independently of each other, introduced the recommendation that HF with LBBB morphology is the only class I indication for CRT, regardless of New York Heart Association (NYHA) class. ![]() 1–3 Recent large clinical trials have shown that patients with prolonged QRS duration in the form of left bundle branch block (LBBB) derive markedly greater benefits than do those with right bundle branch block (RBBB) or non-specific intraventricular conduction disturbances (IVCD). It improves not only symptoms, quality of life, and heart function, but also remarkably reduces HF-related hospitalization and mortality. Presence of LBBB with mid-QRS notching or slurring is a strong predictor of super-response to CRT and may help to identify patients suitable for this treatment.Ĭardiac resynchronization therapy (CRT) has proved to be a very effective treatment for patients with depressed left ventricular (LV) function, symptomatic congestive heart failure (HF), and abnormal QRS width. ![]() Patients with heart failure and specific LBBB configuration, namely mid-QRS notching or slurring in front-to-back (V1, V2) or left-to-right leads (I, aVL, V5, V6), have better response to CRT than do patients with LBBB without notches or with intraventricular conduction delays. This study focuses on a recent clinical hot spot: identification of true left bundle branch block (LBBB) by QRS morphology and its significance regarding cardiac resynchronization therapy (CRT). Multivariate analysis showed that t-LBBB (odds ratio, OR, 11.680 95% confidence interval, CI, 1.966–69.390 P = 0.007) and left ventricular end-diastolic dimension (OR, 0.891 95% CI, 0.797–0.996 P = 0.043) are independent predictors of super-response to CRT. All patients with t-LBBB were responders, some were super-responders. IVCD) and changes in mean New York Heart Association class were −1.2 ± 0.6 in t-LBBB, −0.8 ± 0.6 in nt-LBBB ( P = 0.071), and −0.5 ± 0.6 in IVCD ( P = 0.01, t-LBBB vs. At 6 month follow-up, mean absolute increases in left ventricular ejection fraction were 16.0% ± 11.6% in t-LBBB, 8.1% ± 11.2% in nt-LBBB ( P = 0.02), and 3.3% ± 7.8% in IVCD ( P < 0.001, t-LBBB vs. We prospectively enrolled 58 patients with heart failure and allocated them to three groups: true LBBB (t-LBBB, n = 22) non-true LBBB (nt-LBBB, LBBB with no notch or notches in fewer than two of the leads, n = 17) and non-specific intraventricular conduction delay (IVCD, n = 19). We defined true LBBB as conventional LBBB plus QRS duration ≥130 ms and mid-QRS notching/slurring in at least two of the leads I, aVL, V1, V2, V5, or V6. ![]()
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