Cardiac resynchronization therapy can lead to complete normalization of left ventricular function in select patients with non-ischemic dilated cardiomyopathy and LBBB, suggesting LBBB itself may be a primary etiology of the cardiomyopathy.
CRT may normalize LVEF in select non-ischemic DCM with LBBB; hypothesis-generating and should not change practice yet.
Patients with chronic heart failure (HF) not infrequently present conduction disturbances, which are most commonly exhibited as a left bundle branch block (LBBB). LBBB is associated with intraventricular conduction delay, paradoxical septal motion, and hemodynamic deterioration, indicating an impairment of left ventricular (LV) function. However, there is controversy as to whether dilated cardiomyopathy leading to HF could develop just as a result of conduction disturbances without apparent pre-existing heart disease. We report here 2 cases of patients with non-ischemic dilated cardiomyopathy and LBBB who had complete reversal of their LV dysfunction and enlargement after cardiac resynchronization therapy, which corrects the LV activation sequence. These cases might support the idea that conduction disturbances themselves can be a principal etiology in the development of dilated cardiomyopathy.
No takes yet. Share an insight, caveat, or question.
Fujii et al. (2008) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: