12/17/2023 0 Comments Ivcd rhythmHowever clinical and/or echocardiographic response is present in only 50-70% of CRT pts, suggesting that the link between standard criteria for CRT and expected response is often weak. Pts with non-LBBB pattern show significantly less benefit from CRT than those with LBBB.Ĭardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients (pts) with congestive heart failure improving clinical status and favoring ventricular reverse remodeling. Presence of a LBBB is a marker of a positive response to CRT in terms of biventricular improvement. ![]() At multivariate analysis, LBBB was the only predictor of LVEF response (OR, 7.45 95% CI 1.80-30.94 p = 0.006), but not QRS duration or extent of mechanical dyssynchrony. RVEF was significantly improved in LBBB (+5.0 ± 9.0%, p = 0.007), but not in non-specific IVCD and RBBB pts (+0.4 ± 5.8%, p = 0.76). ![]() 24% of non-specific IVCD pts (p = 0.006). Response (defined as ≥ 5% increase in LVEF) was observed in 68% of LBBB vs. LBBB pts had significantly greater improvement in LVEF compared to RBBB or non-specific IVCD pts (+9.6 ± 10.9% vs. We enrolled 56 pts, 32 with left bundle branch block (LBBB), 4 with right bundle branch block (RBBB) and 20 with non-specific intraventricular conduction disturbance (IVCD). Changes in left and right ventricular EF (LVEF and RVEF) were analyzed with regard to baseline QRS pattern. The relationship between baseline QRS pattern and mechanical dyssynchrony using phase analysis was evaluated. MethodsĬonsecutive patients (pts) undergoing CRT implantation underwent radionuclide angiography at baseline and at mid-term follow-up. We evaluated the role of baseline QRS pattern to predict response in terms of improvement in biventricular ejection fraction (EF). ![]() Predicting response to cardiac resynchronization therapy (CRT) remains a challenge.
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