Does intracardiac delineation of septal conduction improve the characterization of conduction block compared to surface ECG in patients with LBBB pattern?
Intracardiac mapping reveals that surface ECG criteria for LBBB incompletely predict true complete conduction block, suggesting intracardiac data may refine patient selection for cardiac resynchronization therapy.
Heterogeneous septal conduction was observed in patients with surface LBBB pattern, ranging from no discrete block to CCB. When block was present, we observed pathology localized within the left-sided His fibers (left intrahisian block), which was most amenable to corrective His bundle pacing by recruitment of latent Purkinje fibers. ECG criteria for LBBB incompletely predicted CCB, and intracardiac data might be useful in refining patient selection for resynchronization therapy.
Upadhyay et al. (2019) studied this question.
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