Greater response to cardiac resynchronization therapy in patients with true complete left bundle branch block: a PREDICT substudy
Key result
CRT in patients with complete LBBB without residual conduction yielded greater LVEF improvement compared to those with residual conduction (11.9% vs 3.8%, P=0.045).
Why the study?
Does the absence of ECG markers of residual left bundle conduction predict a greater response to cardiac resynchronization therapy in patients with guideline-defined LBBB?
Population
40 patients with heart failure and a wide QRS complex, prospectively enrolled and subdivided into complete…
Comparison
Cardiac resynchronization therapy in patients… vs Cardiac resynchronization therapy in patients…
Design
Cohort
Authors
Discussion
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Implication
Supports ECG-based LBBB refinement for CRT response prediction; hypothesis-generating and requires randomized validation before practice change.
Study Design
Type
Cohort (n=40)
Structured PICO
Does the absence of ECG markers of residual left bundle conduction predict a greater response to cardiac resynchronization therapy in patients with guideline-defined LBBB?
P
Population
40 patients with heart failure and a wide QRS complex, prospectively enrolled and subdivided into complete LBBB (n=12), LBBB with residual LB conduction (n=15), and non-specific intraventricular conduction delay (n=13).
I
Intervention
Cardiac resynchronization therapy (CRT) in patients with complete LBBB (absence of r wave ≥1 mm in lead V1 and q wave ≥1 mm in lead aVL)
C
Comparator
Cardiac resynchronization therapy (CRT) in patients with LBBB with residual LB conduction or non-specific intraventricular conduction delay (IVCD)
O
Outcome
Mean change in left ventricular ejection fraction following CRTsurrogate
Main Result
Absolute Event Rate: 11.9% vs 3.8%
p-value: p=0.045
The absence of ECG markers of residual left bundle conduction (true complete LBBB) predicts a significantly greater improvement in left ventricular function following cardiac resynchronization therapy.
Cite This Study
Perrin et al. (2011) conducted a cohort in Heart failure with wide QRS complex (n=40). Cardiac resynchronization therapy (CRT) in complete LBBB vs. CRT in LBBB with residual conduction or IVCD was evaluated on Mean change in left ventricular ejection fraction (p=0.045). CRT in patients with complete LBBB without residual conduction yielded greater LVEF improvement compared to those with residual conduction (11.9% vs 3.8%, P=0.045).