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Ventricular Dyssynchrony Patterns in Left Bundle Branch Block, With and Without Heart Failure

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Author(s): Hygriv B Rao | Raghu Krishnaswami | Sharada Kalavakolanu | Narasimhan Calambur

Journal: Indian Pacing and Electrophysiology Journal
ISSN 0972-6292

Volume: 10;
Issue: 3;
Start page: 115;
Date: 2010;
Original page

Keywords: Heart Failure | Dyssynchrony | Tissue Doppler Imaging | LBBB | Normal Heart

ABSTRACT
Background: Assessment of ventricular dyssynchrony in patients with heart failure is used for selecting candidates for cardiac resynchronization therapy (CRT). The patterns of regional distribution of dyssynchrony in a population with LBBB with and without heart failure have not been well delineated. This aspect forms the object of the study.Methods: Tissue Doppler Imaging (TDI) data of consecutive patients with heart failure and LBBB (Group A) was compared with those with LBBB and normal LV function (Group B). All patients had standard 2D-echocardigraphic examination and TDI. Tissue velocity curves obtained by placing sample volumes in opposing basal and mid segments of septal, lateral, inferior, anterior and posterior walls were analyzed. Inter ventricular dyssynchrony (IVD) was assessed by the difference between aortic and pulmonary pre ejection intervals. LV dyssynchrony (LVD) was assessed by the difference in times to peak velocity. A delay of ≥ 40 msec was considered significant for presence of IVD and LVD.Results: There were 103 patients in Group A and 25 in Group B. The mean QRS duration and PR intervals respectively were 146 ± 25 vs. 152±20 msec and 182± 47 vs. 165±36 msec. (p=NS) LVEF in the 2 groups were (32 ± 6 % vs. 61± 11%; p< 0.01). Prevalence of dyssynchrony in the HF group compared to Group B was 72% vs. 16%, (P
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