Abstract
Objective:To determine the frequency of intraventricular dyssynchrony among patients with left bundle branch block.Methods:The study was conducted at Hayatabad Medical Complex, Peshawar, from January, 2017 to July, 2017. All patients aged 18 years and above with Left Bundle Branch Block (LBBB) on ECG with or without heart failure were included in the study. Patients with valvular heart disease, predominant diastolic heart failure, acute coronary syndromes or coronary revascularization in last three months and atrial fibrillation were excluded. Tissue Doppler Imaging (TDI) parameters were measured from 2-D images in apical 4-chamber and 2-chamber views. Consecutive non-probability sampling technique was used for sample collection.Results:Our study included 159 patients. Mean age was 52 years with SD ± 2.74. Ninety-nine (62%) patients were male and 60 (38%) patients were female. One hundred and three (65%) patients had heart failure while 56 (35%) patients didn’t have heart failure. More over in our study 124 (78%) patients had Intraventricular dyssynchrony while 35(22%) patients didn’t have Intraventricular dyssynchrony.Conclusion:The incidence of Intraventricular dyssynchrony is high among patients with heart failure and left bundle branch block.
Highlights
Left bundle branch block (LBBB) is an abnormality of cardiac conduction system which causes delayed activation of left ventricle leading to delayed left ventricular contraction compared to the right ventricle
Intraventricular Dyssynchrony characteristics including age, gender, heart failure was statistically significant among both groups (Table-I)
Our study showed the incidence of Intraventricular dyssynchrony in LBBB was 124(78%)
Summary
Left bundle branch block (LBBB) is an abnormality of cardiac conduction system which causes delayed activation of left ventricle leading to delayed left ventricular contraction compared to the right ventricle. Biventricular pacing / cardiac resynchronization therapy (CRT) may improve clinically significant and progressive morbidity associated with concomitant congestive heart failure.[2] Left Ventricular (LV) dyssynchrony is an important mechanism which plays a pivotal part in progression of heart failure and ventricular remodeling. In patients having complete LBBB, there is dyssynchrony between interventricular septal activation and that of LV lateral wall. The aim of CRT using biventricular pacing is to improve global LV function by synchronizing activation of the inter-ventricular septum with that of the LV lateral wall.[3]
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