Scar burden, not QRS pattern, is independently associated with adverse clinical outcomes.Ĭardiac resynchronization Intraventricular conduction delay Ischemic cardiomyopathy Left bundle-branch block Scar burden.Ĭopyright © 2018 Heart Rhythm Society. IVCD is associated with greater scar burden than LBBB in ICM CRT-defibrillator recipients. Scar burden but not QRS morphology was independently associated with these outcomes on multivariate analysis. During 39-month follow-up, IVCD was associated with shorter survival free from transplant/ventricular assist device and shorter time to first appropriate device shock. represents a non-specific intraventricular conduction delay as a result of left. LVEF improved less in patients with IVCD vs LBBB, but only scar burden not QRS morphology or duration was associated with LVEF increase ≥5%. Yhteenvetona todetaan, ett LBBB, IVCD ja QRS keston pidentyminen. QRS duration greater than 110 ms in adults. Nonspecific or Unspecified Intraventricular Conduction Disturbance. IVCD patients demonstrated less QRS narrowing with CRT than LBBB patients, even when excluding IVCD patients with QRS duration <150 ms. Absence of q wave in leads I, V5, and V6. With complete bundle branch blocks, the QRS interval is classically stated to be greater than or equal to 120 ms (0.12 s) in duration (three small 40 ms box widths on standard ECG displays) with incomplete blocks, the QRS interval is defined between 100 (or 110 by computer) and 120 ms (0.10 or 0.11 by computer to 0.12 s). Rickard J, Kumbhani DJ, Gorodeski EZ, Baranowski B, Wazni O, Martin DO, Grimm R, Wilkoff BL. Cardiac resynchronization therapy in non-left bundle branch block morphologies. Nonspecific IVCD is associated with greater scar burden and narrower baseline QRS duration than LBBB. Medline ® Abstract for Reference 42 of Right bundle branch block. We compared scar burden QRS duration LVEF change risk of death, transplant, or ventricular assist device and risk of appropriate device shocks between LBBB and IVCD patients, using multivariable analyses to determine relative associations between QRS pattern vs scar burden and outcomes. We analyzed 393 consecutive ICM patients with left ventricular ejection fraction (LVEF) ≤35%, QRS duration >120 ms, and LBBB or nonspecific IVCD who underwent single-photon emission computed tomography myocardial perfusion imaging and CRT-defibrillator implant. The purpose of this study was to determine whether post-CRT outcome differences in patients with ischemic cardiomyopathy (ICM) relate to intrinsic QRS pattern and/or scar burden. Patients with nonspecific intraventricular conduction delay (IVCD) benefit less from cardiac resynchronization therapy (CRT) than patients with left bundle branch block (LBBB). Cardiac resynchronization therapy-defibrillator (CRT-D) implantation is associated with improvements in heart failure (HF) symptoms and all-cause mortality in patients with symptomatic HF, prolonged QRS duration (QRSd), and left ventricular ejection fraction (EF) 35.
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