PMID- 29294014
OWN - NLM
STAT- MEDLINE
DCOM- 20190620
LR  - 20191210
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 20
IP  - 11
DP  - 2018 Nov 1
TI  - Patients with right bundle branch block and concomitant delayed left ventricular 
      activation respond to cardiac resynchronization therapy.
PG  - e171-e178
LID - 10.1093/europace/eux362 [doi]
AB  - AIMS: Right bundle branch block (RBBB) typically presents with only delayed right 
      ventricular activation. However, some patients with RBBB develop concomitant 
      delayed left ventricular (LV) activation. Such patients may show a specific 
      electrocardiographic (ECG) pattern resembling RBBB in the precordial leads in 
      association with an insignificant S-wave in lateral limb leads (atypical RBBB). 
      We therefore postulated that the ECG pattern of atypical RBBB might be able to 
      identify a subgroup of patients likely to respond to cardiac resynchronization 
      therapy (CRT). The purpose of this study was to assess the impact of RBBB ECG 
      morphology on CRT response in patients with heart failure (HF). METHODS AND 
      RESULTS: We evaluated the echocardiographic clinical response of 66 patients with 
      RBBB treated with CRT and followed up for almost 2 years. The patients were 
      divided electrocardiographically into 2 groups: 31 with typical RBBB and 35 with 
      atypical RBBB. Responders were classified in terms of reduction in LV 
      end-systolic volume index (ESVi) >/= 15% or reduction in the New York Heart 
      Association (NYHA) Class >/= 1 or Packer score variation (NYHA response with no 
      HF-related hospitalization events or death). The atypical RBBB group presented a 
      longer LV activation time compared with the typical RBBB group (111.9 +/- 17.6 vs. 
      73.2 +/- 15.4 ms; P < 0.001). In the atypical and typical RBBB groups, 
      respectively, 71.4% and 19.4% of patients were ESVi responders (P = 0.001) 74.3% 
      and 32.3% were NYHA responders (P = 0.002); similarly, 71.4% and 29.0% of 
      patients exhibited a 2-year Packer score of 0 (P = 0.002). CONCLUSION: Patients 
      with atypical RBBB, which is a pattern highly suggestive of concomitant delayed 
      LV conduction, may show a satisfactory response to CRT.
FAU - Pastore, Gianni
AU  - Pastore G
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Morani, Giovanni
AU  - Morani G
AD  - Department of Cardiology, University of Verona, Verona, Italy.
FAU - Maines, Massimiliano
AU  - Maines M
AD  - Department of Cardiology, Rovereto General Hospital, Rovereto, Italy.
FAU - Marcantoni, Lina
AU  - Marcantoni L
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Bolzan, Bruna
AU  - Bolzan B
AD  - Department of Cardiology, University of Verona, Verona, Italy.
FAU - Zanon, Francesco
AU  - Zanon F
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Noventa, Franco
AU  - Noventa F
AD  - Department of Molecular Medicine, University of Padua, Padova, Italy.
FAU - Corbucci, Giorgio
AU  - Corbucci G
AD  - Boston Scientific, Milan, Italy.
FAU - Baracca, Enrico
AU  - Baracca E
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Picariello, Claudio
AU  - Picariello C
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Lanza, Daniela
AU  - Lanza D
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Zuin, Marco
AU  - Zuin M
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Roncon, Loris
AU  - Roncon L
AD  - Department of Cardiology, Rovigo General Hospital, via Tre Martiri, Rovigo, 
      Italy.
FAU - Barold, S Serge
AU  - Barold SS
AD  - Department of Medicine, University of Rochester School of Medicine and Dentistry, 
      Rochester, NY, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Aged
MH  - *Bundle-Branch Block/complications/diagnosis/physiopathology/therapy
MH  - *Cardiac Resynchronization Therapy/methods/statistics & numerical data
MH  - Echocardiography/*methods
MH  - Electrocardiography/methods
MH  - Female
MH  - Heart Conduction System/*physiopathology
MH  - *Heart Failure/diagnosis/physiopathology/therapy
MH  - Heart Ventricles/*physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
EDAT- 2018/01/03 06:00
MHDA- 2019/06/21 06:00
CRDT- 2018/01/03 06:00
PHST- 2017/09/07 00:00 [received]
PHST- 2017/11/29 00:00 [accepted]
PHST- 2018/01/03 06:00 [pubmed]
PHST- 2019/06/21 06:00 [medline]
PHST- 2018/01/03 06:00 [entrez]
AID - 4774616 [pii]
AID - 10.1093/europace/eux362 [doi]
PST - ppublish
SO  - Europace. 2018 Nov 1;20(11):e171-e178. doi: 10.1093/europace/eux362.