Heart failure patients with RBBB had significantly longer time to right ventricular breakthrough (P<0.001) and shorter time to left ventricular breakthrough (P<0.001) compared to patients with LBBB.
Cross-Sectional (n=100)
What are the differences in right and left ventricular activation sequences between heart failure patients with RBBB versus LBBB?
Heart failure patients with RBBB have a similar degree of LV activation delay as those with LBBB, providing an electrophysiological rationale for considering cardiac resynchronization therapy in this population.
p-value: p=<0.001
UNLABELLED: Three-dimensional mapping in RBBB and heart failure. INTRODUCTION: Recently, right bundle branch block (RBBB) was proved to be an important predictor of mortality in heart failure (HF) patients as much as left bundle branch block (LBBB). We characterized endocardial right ventricular (RV) and left ventricular (LV) activation sequence in HF patients with RBBB using a three-dimensional non-fluoroscopic electroanatomic contact mapping system (3D-Map) in order to provide the electrophysiological background to understand whether these patients can benefit from cardiac resynchronization therapy (CRT). METHODS AND RESULTS: Using 3D-Map, RV and LV activation sequences were studied in 100 consecutive HF patients. Six of these patients presented with RBBB QRS morphology. The maps of these patients were analyzed and compared post hoc with those of the other 94 HF patients presenting with LBBB. Clinical and hemodynamic profile was significantly worse in RBBB group compared to LBBB. Patients with RBBB showed significantly longer time to RV breakthrough (P<0.001), longer activation times of RV anterior and lateral regions (P<0.001), and longer total RV endocardial activation time (P<0.02) compared to patients with LBBB. Time to LV breakthrough was significantly shorter in patients with RBBB (P<0.001), while total and regional LV endocardial activation times were not significantly different between the two groups. CONCLUSIONS: Degree of LV activation delay is similar between HF patients with LBBB and RBBB. Moreover, patients with RBBB have larger right-sided conduction delay compared to patients with LBBB. The assessment of these electrical abnormalities is important to understand the rationale for delivering CRT in HF patients with RBBB.
Fantoni et al. (Tue,) conducted a cross-sectional in Heart failure (n=100). Right bundle branch block (RBBB) vs. Left bundle branch block (LBBB) was evaluated on Right ventricular (RV) and left ventricular (LV) activation sequence (p=<0.001). Heart failure patients with RBBB had significantly longer time to right ventricular breakthrough (P<0.001) and shorter time to left ventricular breakthrough (P<0.001) compared to patients with LBBB.