What does this research mean for the field?

In patients with left bundle branch block, epicardial activation is characterized by early right ventricular breakthrough, absence of discrete left ventricular breakthroughs, slow right-to-left transseptal activation, and abnormally late left ventricular epicardial activation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to investigate the ventricular activation sequence abnormalities in patients with left bundle branch block (LBBB).

April 1, 1980CirculationOpen Access

Epicardial activation in patients with left bundle branch block.

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Why the study?

What are the abnormalities in ventricular activation sequence in human left bundle branch block as determined by epicardial mapping?

Population

5 patients, ages 52-58 years, undergoing coronary bypass surgery, with left bundle branch block.

Comparison

Epicardial mapping during surgery vs Published data from patients without conduction…

Design

Case_series

Authors

CWChristopher R.C. WyndhamEast Sussex County Council TSThomas W. SmithBoston University MMM K MeeranLouisiana State University

Discussion

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Implication

Case-report epicardial mapping refines LBBB activation patterns; hypothesis-generating and should not yet alter CRT selection.

Key Points

The study aims to investigate the ventricular activation sequence abnormalities in patients with left bundle branch block (LBBB).
Epicardial mapping performed in five patients with LBBB undergoing coronary bypass surgery.
Comparison of activation sequences to published data from patients without conduction defects.
Assessment of QRS duration and epicardial breakthrough timings during LBBB.
Patients with chronic LBBB showed abnormally early anterior RV epicardial breakthrough at 5-26 msec after QRS onset.
Latest LV epicardial activation occurred abnormally late at 113-140 msec after QRS onset in all patients.
Absence of discrete LV epicardial breakthroughs was observed in all patients.

Structured PICO

What are the abnormalities in ventricular activation sequence in human left bundle branch block as determined by epicardial mapping?

Population

5 patients, ages 52-58 years, undergoing coronary bypass surgery, with left bundle branch block (3 chronic, 2 intraoperative).

Intervention

Epicardial mapping during surgery

Comparator

Published data from patients without conduction defect (and preoperative maps for the 2 intraoperative LBBB patients)

Outcome

Abnormalities in ventricular activation sequence (epicardial breakthrough timing/location, transseptal activation, LV epicardial activation)surrogate

Epicardial mapping in human LBBB demonstrates that delayed left ventricular activation is characterized by an absence of discrete LV breakthroughs and slow transseptal conduction.

Cite This Study

Wyndham et al. (1980) studied this question.

synapsesocial.com/papers/6a153deecb0379474a820bf5 https://doi.org/10.1161/01.cir.61.4.696

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Epicardial activation in patients with left bundle branch block.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Epicardial activation in patients with left bundle branch block.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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