PMID- 20025703
OWN - NLM
STAT- MEDLINE
DCOM- 20100927
LR  - 20161125
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 33
IP  - 5
DP  - 2010 May
TI  - Cardiac resynchronization therapy in non-left bundle branch block morphologies.
PG  - 590-5
LID - 10.1111/j.1540-8159.2009.02649.x [doi]
AB  - INTRODUCTION: In select patients with systolic heart failure, cardiac 
      resynchronization therapy (CRT) has been shown to improve quality of life, 
      exercise capacity, ejection fraction (EF), and survival. Little is known about 
      the response to CRT in patients with right bundle branch block (RBBB) or 
      non-specific intraventricular conduction delay (IVCD) compared with traditionally 
      studied patients with left bundle branch block (LBBB). METHODS: We assessed 542 
      consecutive patients presenting for the new implantation of a CRT device. 
      Patients were placed into one of three groups based on the preimplantation 
      electrocardiogram morphology: LBBB, RBBB, or IVCD. Patients with a narrow QRS or 
      paced ventricular rhythm were excluded. The primary endpoint was long-term 
      survival. Secondary endpoints were changes in EF, left ventricular end-diastolic 
      and systolic diameter, mitral regurgitation, and New York Heart Association 
      (NYHA) functional class. RESULTS: Three hundred and thirty-five patients met 
      inclusion criteria of which 204 had LBBB, 38 RBBB, and 93 IVCD. There were 32 
      deaths in the LBBB group, 10 in the RBBB, and 27 in the IVCD group over a mean 
      follow up of 3.4 +/- 1.2 years. In multivariate analysis, no mortality difference 
      amongst the three groups was noted. Patients with LBBB had greater improvements 
      in most echocardiographic endpoints and NYHA functional class than those with 
      IVCD and RBBB. CONCLUSION: There is no difference in 3-year survival in patients 
      undergoing CRT based on baseline native QRS morphology. Patients with RBBB and 
      IVCD derive less reverse cardiac remodeling and symptomatic benefit from CRT 
      compared with those with a native LBBB.
FAU - Rickard, John
AU  - Rickard J
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio 44195, 
      USA. rickarj2@ccf.org
FAU - Kumbhani, Dharam J
AU  - Kumbhani DJ
FAU - Gorodeski, Eiran Z
AU  - Gorodeski EZ
FAU - Baranowski, Bryan
AU  - Baranowski B
FAU - Wazni, Oussama
AU  - Wazni O
FAU - Martin, David O
AU  - Martin DO
FAU - Grimm, Richard
AU  - Grimm R
FAU - Wilkoff, Bruce L
AU  - Wilkoff BL
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20091216
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Bundle-Branch Block/diagnostic imaging/mortality/*therapy
MH  - Cardiac Pacing, Artificial/*methods
MH  - Cohort Studies
MH  - Female
MH  - Heart Failure, Systolic/diagnostic imaging/mortality/*therapy
MH  - Heart Ventricles/diagnostic imaging/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Pacemaker, Artificial
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ultrasonography
EDAT- 2009/12/23 06:00
MHDA- 2010/09/29 06:00
CRDT- 2009/12/23 06:00
PHST- 2009/12/23 06:00 [entrez]
PHST- 2009/12/23 06:00 [pubmed]
PHST- 2010/09/29 06:00 [medline]
AID - PACE2649 [pii]
AID - 10.1111/j.1540-8159.2009.02649.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2010 May;33(5):590-5. doi: 
      10.1111/j.1540-8159.2009.02649.x. Epub 2009 Dec 16.