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Rajeev Bhardwaj
PURPOSE OF STUDY: Left bundle branch (LBBB) is common ECG finding. Common causes of LBBB are coronary artery disease (CAD), hypertension and dilated cardiomyopathy (DCM). Purpose of the study was to find out the etiology and left ventricular function in patients coming to a territory care hospital. MATERIAL AND METHODS: All consecutive patients coming to our hospital as indoor or outdoor patients with ECG suggestive of LBBB were studied. The detail history and examination was done...
September 2016: Journal of the Association of Physicians of India
John Rickard, Henry Michtalik, Ritu Sharma, Zackary Berger, Emmanuel Iyoha, Ariel R Green, Nowreen Haq, Karen A Robinson
BACKGROUND: Multiple studies have sought to determine variables associated with improved "response" to cardiac resynchronization therapy(CRT). Such variables, however, are often derived from inadequately controlled, single center cohort studies calling external validity into question. We sought to determine predictors of response to CRT-D and CRT-P utilizing the methods of systematic review. METHODS: We searched MEDLINE, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 1995, as this is the date of first article reporting use of CRT through October 20, 2014...
September 25, 2016: International Journal of Cardiology
Onur Kaypakli, Mevlüt Koç, Gökhan Gözübüyük, Durmuş Yıldıray Şahin
AIM: CRT was shown to improve HF prognosis. But many patients do not benefit from CRT. Optimization of LV lead position to the latest activated LV area is important to increase CRT response. We aimed to detect the relationship between LV lead sensing delay and echocardiographic and electrocardiographic response to CRT treatment. METHODS: We prospectively included 156 consecutive patients with HF diagnosis, QRS≥120 ms, LBBB, NYHA II-IV, LVEF<35% and scheduled for CRT (100 male, 56 female; mean age 65...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
Ali Vasheghani-Farahani, Masih Tajdini, Seyed Abolfazl Mohsenizadeh, Seyed Mohammad Reza Hosseini
BACKGROUND: Cardiac resynchronization therapy (CRT) is a medical device to help cardiac synchronized contractility by electrical impulses. Improvement of symptoms and left ventricular systolic function, reducing hospital admissions and mortality in patients with moderate to severe heart failure are the main benefits of administration of cardiac resynchronization therapy. CASE REPORT: In this article, we describe a case of heart failure and left bundle branch block (LBBB) who was candidate for cardiac resynchronization therapy; but after managing hyperkalemia, left bundle branch block resolved, ejection fraction increased and cardiac resynchronization therapy implantation was canceled...
May 2016: ARYA Atherosclerosis
Akm Monwarul Islam, Md Toufiqur Rahman, Abu Hana Chowdhury
Naxos disease is a rare autosomal recessive form of arrhythmogenic right ventricular cardiomyopathy (ARVC) with woolly hair and palmoplantar keratoderma. The cardiomyopathy presents by adolescence with syncope, ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology, and/or ventricular fibrillation. The diagnosis and management of ARVC are at present in evolution; the recently published modified Task Force Criteria for diagnosis and International Task Force consensus statement for treatment of ARVC will hopefully bring about uniformity in recognition and management of Naxos disease as well...
October 2016: Cardiovascular Diagnosis and Therapy
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hui Yang, Fabio Leonelli
QRS morphology is commonly used in the electrocardiographic diagnosis of ventricular depolarization such as left bundle branch block (LBBB) and ventricular septal infarction. We investigated whether pattern matching of QRS loops in the 3-dimensional vectorcardiogram (VCG) will improve the grouping of patients whose space-time electrical activity akin to each other, thereby assisting in clinical decision making. First, pattern dissimilarity of VCG QRS loops is qualitatively measured and characterized among patients, resulting in a 93×93 distance matrix of patient-to-patient dissimilarity...
September 28, 2016: Computers in Biology and Medicine
A Zweerink, L Wu, G J de Roest, R Nijveldt, C C de Cock, A C van Rossum, C P Allaart
AIMS: This study evaluates the relative importance of two components of QRS prolongation, myocardial conduction velocity and travel distance of the electrical wave front (i.e. path length), for the prediction of acute response to cardiac resynchronization therapy (CRT) in left bundle branch block (LBBB) patients. METHODS: Thirty-two CRT candidates (ejection fraction <35%, LBBB) underwent cardiac magnetic resonance (CMR) imaging to provide detailed information on left ventricular (LV) dimensions...
October 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Julian Ck Tay, Liou Wei Lun, Zhong Liang, Terrance Sj Chua, Swee Han Lim, Aaron Sl Wong, Marcus Eh Ong, Kay Woon Ho
INTRODUCTION: Door-to-balloon (DTB) time is critical to ST elevation myocardial infarction (STEMI) patients' survival. Although DTB time is reduced with direct cardiovascular laboratory (CVL) activation by emergency physicians, concerns regarding false-positive activation remain. We evaluate false-positive rates before and after direct CVL activation and factors associated with false-positive activations. MATERIALS AND METHODS: This is a retrospective single centre study of all emergency CVL activation 3 years before and after introduction of direct activation in July 2007...
August 2016: Annals of the Academy of Medicine, Singapore
Parikshit S Sharma, Faiz A Subzposh, Kenneth A Ellenbogen, Pugazhendhi Vijayaraman
BACKGROUND: Conduction disease is not uncommon after prosthetic valve (PV) surgery. The feasibility of His bundle pacing (HBP) in this patient (pt) population is not well studied. OBJECTIVE: We report our experience with permanent HBP in pts undergoing pacemaker (PM) implantation following PV surgery. METHODS: Permanent HBP was attempted in pts with AV conduction disease post PV surgery referred for PM implantation. Conduction disease was characterized as AV nodal vs infra-nodal...
September 20, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
John J Wang, Olle Pahlm, Galen S Wagner, James W Warren, B Milan Horáček, John L Sapp
BACKGROUND: Existing criteria recommended by ACC/ESC for identifying patients with ST elevation myocardial infarction (STEMI) from the 12-lead ECG perform with high specificity (SP) but low sensitivity (SE). In our previous studies, we found that the SE of acute ischemia detection can be markedly improved without any loss of SP by calculating, from the 12-lead ECG, ST deviation in 3 "optimal" vessel-specific leads (VSLs). To further validate the method, we evaluated the SP performance using a dataset with non-ischemic ST-segment changes...
August 18, 2016: Journal of Electrocardiology
José López-Aguilera, José M Segura Saint-Gerons, Francisco Mazuelos Bellido, Javier Suárez de Lezo Herreros de Tejada, Soledad O Pineda, Manuel Pan Álvarez-Ossorio, Miguel Ángel Romero Moreno, Djordje Pavlovic, José Suárez de Lezo Cruz Conde
New-onset conduction disturbances are common after transcatheter aortic valve implantation (TAVI). The most common complication is left bundle branch block (LBBB). The clinical impact of new-onset LBBB after TAVI remains controversial. The aim of this study was to analyze the clinical impact of new-onset LBBB in terms of mortality and morbidity (need for pacemakers and admissions for heart failure) at long-term follow-up. From April 2008 to December 2014, 220 patients who had severe aortic stenosis were treated with the implantation of a CoreValve prosthesis...
August 12, 2016: American Journal of Cardiology
Andrew Mathias, Arthur J Moss, Scott McNitt, Wojciech Zareba, Ilan Goldenberg, Scott D Solomon, Valentina Kutyifa
BACKGROUND: Clinical implications of complete left-sided reverse remodeling due to cardiac resynchronization therapy with a defibrillator (CRT-D), defined as reduction in both left ventricular end-systolic volume (LVESV) and left atrial volume (LAV), are unknown. OBJECTIVES: This study aimed to evaluate the rate and predictive value of complete left-sided reverse remodeling on heart failure (HF) and death events in CRT-D patients with left bundle branch block (LBBB) enrolled in MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)...
September 20, 2016: Journal of the American College of Cardiology
Usama A Daimee, Yitschak Biton, Arthur J Moss, Wojciech Zareba, David Cannom, Helmut Klein, Scott Solomon, Martin H Ruwald, Scott McNitt, Bronislava Polonsky, Paul J Wang, Ilan Goldenberg, Valentina Kutyifa
BACKGROUND: The effect of chronic kidney disease (CKD) on benefit from cardiac resynchronization therapy with defibrillator (CRT-D) in reducing ventricular tachyarrhythmia (VTA) risk among mild heart failure (HF) patients is not well understood. METHODS: We evaluated the impact of baseline renal function on VTAs in 1274 left bundle branch block (LBBB) patients enrolled in MADIT-CRT. Two prespecified subgroups were created based on estimated glomerular filtration rate (GFR): GFR <60 (n = 413) and GFR ≥60 ml/min/1...
September 15, 2016: Annals of Noninvasive Electrocardiology
Chance M Witt, Gang Wu, Dachun Yang, David O Hodge, Veronique L Roger, Yong-Mei Cha
OBJECTIVES: This study aimed to define the prognosis for patients with left bundle branch block (LBBB) and a mildly to moderately reduced left ventricular ejection fraction (LVEF) (36% to 50%) as well as to clarify whether LBBB remained a negative prognostic marker in this group. BACKGROUND: LBBB is associated with worse outcomes in patients with heart failure in the setting of severely reduced LVEF. The level of morbidity and mortality associated with LBBB in the setting of a mildly to moderately reduced LVEF (36% to 50%) has not been clearly characterized...
August 28, 2016: JACC. Heart Failure
Raffaele Corbisiero, David C Buck, David Muller, Rupinder Bharmi, Nirav Dalal, Pedram Kazemian
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) with left ventricular systolic dysfunction and prolonged QRS interval. However, one third of patients do not benefit from treatment. This study compares the heart failure hospitalization (HFH) rates and corresponding costs between responders and non-responders to CRT. METHODS: At a single center in New Jersey, we enrolled patients with de novo CRT-D implants between January 2011 and July 2013...
September 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Fady Dawoud, Karl H Schuleri, David D Spragg, B Milan Horáček, Ronald D Berger, Henry R Halperin, Albert C Lardo
INTRODUCTION: The interplay between electrical activation and mechanical contraction patterns is hypothesized to be central to reduced effectiveness of cardiac resynchronization therapy (CRT). Furthermore, complex scar substrates render CRT less effective. We used novel cardiac computed tomography (CT) and noninvasive electrocardiographic imaging (ECGI) techniques in an ischemic dyssynchronous heart failure (DHF) animal model to evaluate electrical and mechanical coupling of cardiac function, tissue viability, and venous accessibility of target pacing regions...
August 30, 2016: Journal of Cardiovascular Electrophysiology
Marcus Ståhlberg, Frieder Braunschweig, Fredrik Gadler, Lars Mortensen, Lars H Lund, Cecilia Linde
Heart failure (HF) is considered as an epidemic and affects 2% of the population in the Western world. About 15-30% of patients with HF and reduced ejection fraction (HFrEF) also have prolonged QRS duration on the surface ECG, most commonly as a result of left-bundle branch block (LBBB). Increased QRS duration is a marker of a dyssynchronous activation, and subsequent contraction, pattern in the left ventricle (LV). When dyssynchrony is superimposed on the failing heart it further reduced systolic function and ultimately worsens outcome...
August 30, 2016: Scandinavian Cardiovascular Journal: SCJ
Beatriz Toledano, Felipe Bisbal, Maria Luisa Camara, Carlos Labata, Elisabet Berastegui, Carolina Gálvez-Montón, Roger Villuendas, Axel Sarrias, Teresa Oliveres, Damià Pereferrer, Xavier Ruyra, Antoni Bayés-Genís
OBJECTIVES: In high-risk patients with severe aortic stenosis, aortic valve replacement (AVR) with a sutureless Perceval prosthesis (SU-AVR) can be performed instead of conventional AVR or transcatheter aortic valve implantation. Little data are available regarding postoperative conduction disorders after SU-AVR. We aimed to determine the incidence and predictors of new-onset complete atrioventricular block (NO-AVB) requiring permanent cardiac stimulation following SU-AVR. METHODS: We studied consecutive patients who underwent SU-AVR between 2013 and 2015...
August 29, 2016: Interactive Cardiovascular and Thoracic Surgery
Xiaojuan Xia, Anne-Christine Ruwald, Martin H Ruwald, Nene Ugoeke, Barbara Szepietowska, Valentina Kutyifa, Mehmet K Aktas, Poul Erik B Thomsen, Wojciech Zareba, Arthur J Moss, Jean-Philippe Couderc
AIMS: Strict left bundle branch block (LBBB) criteria were recently proposed to identify LBBB patients to benefit most from cardiac resynchronization therapy (CRT). The aim of our study was to automate identification of strict LBBB in order to facilitate its broader application. METHODS: We developed a series of algorithms to automatically detect and measure parameters required for strict LBBB criteria and proposed a definition of QRS notch detection. The algorithms were developed using training (n = 20) and validation (n = 592) sets consisting of signal-averaged 12-lead ECGs (1,000 Hz sampling) recorded from 612 LBBB patients from Multicenter Automatic Defibrillator Implantation Trial-CRT...
August 30, 2016: Annals of Noninvasive Electrocardiology
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