Variable left ventricular activation pattern in patients with heart failure and left bundle branch block: Figure 1
Population
7 patients with chronic heart failure, LV ejection fraction < 35%, and typical LBBB on ECG with QRS duration…
Design
Case_series
Authors
Discussion
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Member takes
Implication
Should not yet change CRT selection; hypothesis-generating for activation mapping in LBBB.
Key Points
- To determine the left ventricular endocardial activation sequences in patients with chronic heart failure and electrocardiographic left bundle branch block.
- Prospective evaluation of seven patients with chronic heart failure (left ventricular ejection fraction < 35% and QRS duration ≥ 130 ms, including five with non-ischaemic dilated cardiomyopathy) at a tertiary cardiology center in Hong Kong.
- Global left ventricular activation sequences were mapped using non-contact mapping and correlated with tissue Doppler imaging.
- Three of seven patients exhibited preserved left bundle activation despite meeting standard electrocardiographic criteria for left bundle branch block.
- Conduction block during left ventricular activation occurred in four patients, whereas three had homogeneous depolarization propagation, with the latest activation localized to the lateral or posterior regions.
- Tissue Doppler imaging findings correlated closely with non-contact mapping in identifying conduction block sites and the latest activating myocardial segments.
Structured PICO
P
Population
7 patients with chronic heart failure, LV ejection fraction < 35%, and typical LBBB on ECG with QRS duration >= 130 ms. 5 patients had non-ischaemic dilated cardiomyopathy. Recruited at a tertiary cardiology referral centre in Hong Kong.
I
Intervention
Non-contact mapping and Tissue Doppler imaging to investigate left ventricular global activation sequences
O
Outcome
Left ventricular (LV) activation pattern and global activation sequencessurrogate
Left ventricular endocardial activation sequences in patients with chronic heart failure and LBBB are highly variable, which may have implications for patient selection for cardiac resynchronization therapy.
Cite This Study
John J. Fung (2003) studied this question.