Circulation, Vol 79, 845-853, Copyright © 1989 by American Heart Association
CL Grines, TM Bashore, H Boudoulas, S Olson, P Shafer and CF Wooley
Eighteen patients with isolated left bundle branch block (LBBB) were
compared with 10 normal control subjects. Apexcardiograms,
phonocardiograms, electrocardiograms, two-dimensional and dual M-mode
echocardiograms, and radionuclide ventriculograms (RNV) were performed.
There were no differences in the timing of right ventricular events between
LBBB and normal subjects; however, striking delays in left ventricular
systolic and diastolic events were apparent in the LBBB group. The delay
was associated with shortening of left ventricular diastole and resultant
increase in the ratio of right to left ventricular diastolic time in LBBB
(1.2 +/- 0.08) compared with normal (1.0 +/- 0.06), p less than 0.0001.
First heart sound (S1) amplitude, expressed as the ratio S1/S2, was
decreased in LBBB compared with normal (0.67 +/- 0.2 compared with 1.34 +/-
0.25, p less than 0.01), in part due to wide separation of the valvular
contributors to S1. The abnormal interventricular septal motion in LBBB
corresponded to periods of asynchrony in contraction, ejection, end
systole, and end diastole between right and left ventricles. Radionuclide
ventriculograms revealed decreased regional ejection fraction of the septum
in LBBB (40 +/- 16%) compared with 67 +/- 7% in normal subjects (p less
than 0.001), while the apical and lateral regional ejection fractions were
similar in the two groups. This loss of septal contribution resulted in a
reduction in global ejection fraction in LBBB compared to normals (54 +/-
7% compared with 62 +/- 5%, p less than 0.005).(ABSTRACT TRUNCATED AT 250
WORDS)
ARTICLES
Functional abnormalities in isolated left bundle branch block. The effect of interventricular asynchrony
Department of Internal Medicine, Ohio State University, Columbus.
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S. Ghio, C. Constantin, C. Klersy, A. Serio, A. Fontana, C. Campana, and L. Tavazzi Interventricular and intraventricular dyssynchrony are common in heart failure patients, regardless of QRS duration Eur. Heart J., April 1, 2004; 25(7): 571 - 578. [Abstract] [Full Text] [PDF]
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G. A. Lamas, K. A. Ellenbogen, and With the Assistance of Charles H. Hennekens, MD, D Evidence Base for Pacemaker Mode Selection: From Physiology to Randomized Trials Circulation, February 3, 2004; 109(4): 443 - 451. [Full Text] [PDF]
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Y. Yu, A. Kramer, J. Spinelli, J. Ding, W. Hoersch, and A. Auricchio Biventricular mechanical asynchrony predicts hemodynamic effect of uni- and biventricular pacing Am J Physiol Heart Circ Physiol, December 1, 2003; 285(6): H2788 - H2796. [Abstract] [Full Text] [PDF]
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S. L. Higgins, J. D. Hummel, I. K. Niazi, M. C. Giudici, S. J. Worley, L. A. Saxon, J. P. Boehmer, M. B. Higginbotham, T. De Marco, E. Foster, et al. Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias J. Am. Coll. Cardiol., October 15, 2003; 42(8): 1454 - 1459. [Abstract] [Full Text] [PDF]
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L Bode-Schnurbus, D Bocker, M Block, R Gradaus, A Heinecke, G Breithardt, and M Borggrefe QRS duration: a simple marker for predicting cardiac mortality in ICD patients with heart failure Heart, October 1, 2003; 89(10): 1157 - 1162. [Abstract] [Full Text] [PDF]
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T. V. Salukhe, M. Y. Henein, and R. Sutton Pacing in heart failure: patient and pacing mode selection Eur. Heart J., June 1, 2003; 24(11): 977 - 986. [Full Text] [PDF]
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F. J. Zimmerman, J. P. Starr, P. R. Koenig, P. Smith, Z. M. Hijazi, and E. A. Bacha Acute hemodynamic benefit of multisite ventricular pacing after congenital heart surgery Ann. Thorac. Surg., June 1, 2003; 75(6): 1775 - 1780. [Abstract] [Full Text] [PDF]
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A. Duncan, D. Wait, D. Gibson, and J.-C. Daubert Left ventricular remodelling and haemodynamic effects of multisite biventricular pacing in patients with left ventricular systolic dysfunction and activation disturbances in sinus rhythm: sub-study of the MUSTIC (Multisite Stimulationin Cardiomyopathies) trial Eur. Heart J., March 1, 2003; 24(5): 430 - 441. [Abstract] [Full Text] [PDF]
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C. Stellbrink and B. Nowak The importance of being synchronous: on the prognostic value of ventricular conduction delay in heart failure J. Am. Coll. Cardiol., December 4, 2002; 40(11): 2031 - 2033. [Full Text] [PDF]
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M. V. Pitzalis, M. Iacoviello, R. Romito, F. Massari, B. Rizzon, G. Luzzi, P. Guida, A. Andriani, F. Mastropasqua, and P. Rizzon Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony J. Am. Coll. Cardiol., November 6, 2002; 40(9): 1615 - 1622. [Abstract] [Full Text] [PDF]
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C. Pislaru, P. C. Anagnostopoulos, J. B. Seward, J. F. Greenleaf, and M. Belohlavek Higher myocardial strain rates duringisovolumic relaxation phase than duringejection characterize acutely ischemic myocardium J. Am. Coll. Cardiol., October 16, 2002; 40(8): 1487 - 1494. [Abstract] [Full Text] [PDF]
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X. A. A. M. Verbeek, K. Vernooy, M. Peschar, T. Van der Nagel, A. Van Hunnik, and F. W. Prinzen Quantification of interventricular asynchrony during LBBB and ventricular pacing Am J Physiol Heart Circ Physiol, October 1, 2002; 283(4): H1370 - H1378. [Abstract] [Full Text] [PDF]
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O. A. Breithardt, C. Stellbrink, A. P. Kramer, A. M. Sinha, A. Franke, R. Salo, B. Schiffgens, E. Huvelle, A. Auricchio, and PATH-CHF Study Group Echocardiographic quantification of left ventricular asynchrony predicts an acute hemodynamic benefit of cardiac resynchronization therapy J. Am. Coll. Cardiol., August 7, 2002; 40(3): 536 - 545. [Abstract] [Full Text] [PDF]
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A. Auricchio, C. Stellbrink, S. Sack, M. Block, J.u. Vogt, P. Bakker, C. Huth, F. Schondube, U. Wolfhard, D. Bocker, et al. long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay J. Am. Coll. Cardiol., June 19, 2002; 39(12): 2026 - 2033. [Abstract] [Full Text] [PDF]
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D. Gras, C. Leclercq, A. S.L. Tang, C. Bucknall, H. O. Luttikhuis, and A. Kirstein-Pedersen Cardiac resynchronization therapy in advanced heart failure the multicenter InSync clinical study Eur J Heart Fail, June 1, 2002; 4(3): 311 - 320. [Abstract] [Full Text] [PDF]
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M. Santini and R. Ricci Biventricular pacing in patients with heart failure and intraventricular conduction delay: state of the art and perspectives. The European view Eur. Heart J., May 1, 2002; 23(9): 682 - 686. [Full Text] [PDF]
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A Auricchio and H.U Klein Beyond expectations: a decade of positive results with cardiac resynchronization therapy for heart failure Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D95 - D101. [Abstract] [PDF]
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G Breithardt, H Kuhn, D Hammel, H.-H Scheld, L Seipel, and D. Bocker Cardiac resynchronization therapy into the next decade: from the past to morbidity/mortality trials Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D102 - D110. [Abstract] [PDF]
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L. A. Saxon, T. De Marco, J. Schafer, K. Chatterjee, U. N. Kumar, and E. Foster Effects of Long-Term Biventricular Stimulation for Resynchronization on Echocardiographic Measures of Remodeling Circulation, March 19, 2002; 105(11): 1304 - 1310. [Abstract] [Full Text] [PDF]
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A. Touiza, Y. Etienne, M. Gilard, M. Fatemi, J. Mansourati, and J.-J. Blanc Long-term left ventricular pacing: assessment and comparison with biventricular pacing in patients with severe congestive heart failure J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1966 - 1970. [Abstract] [Full Text] [PDF]
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