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Bundle Branch Block

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1. Bifocal Right Ventricular PAcing in Right Bundle Branch blocK and Heart Failure With Reduced Ejection Fraction. The Study Tests the Superiority of Right Ventricular Bifocal Stimulation Over VVI Implantable Defibrillator in Right Bundle Branch Block and He

Bifocal Right Ventricular PAcing in Right Bundle Branch blocK and Heart Failure With Reduced Ejection Fraction. The Study Tests the Superiority of Right Ventricular Bifocal Stimulation Over VVI Implantable Defibrillator in Right Bundle Branch Block and He Bifocal Right Ventricular PAcing in Right Bundle Branch blocK and Heart Failure With Reduced Ejection Fraction. The Study Tests the Superiority of Right Ventricular Bifocal Stimulation Over VVI Implantable Defibrillator in Right Bundle Branch (...) Block and Heart Failure. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Bifocal Right Ventricular PAcing in Right Bundle Branch blocK and Heart Failure With Reduced Ejection Fraction. The Study Tests

2018 Clinical Trials

2. Rationale and design for ENHANCE CRT: QLV implant strategy for non-left bundle branch block patients. Full Text available with Trip Pro

Rationale and design for ENHANCE CRT: QLV implant strategy for non-left bundle branch block patients. Historically, cardiac resynchronization therapy (CRT) response in non-left bundle branch block (non-LBBB) patients has been suboptimal in comparison with that observed in left bundle branch block patients. The electrical activation pattern of the left ventricle (LV) is different between these two QRS morphologies. Small non-randomized studies have suggested that targeting the LV wall

2019 ESC heart failure Controlled trial quality: uncertain

3. Diagnosis of acute myocardial infarction in the presence of left bundle branch block (Abstract)

Diagnosis of acute myocardial infarction in the presence of left bundle branch block Patients with suspected acute myocardial infarction (AMI) in the setting of left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to the clinician.We prospectively evaluated the incidence of AMI and diagnostic performance of specific ECG and high-sensitivity cardiac troponin (hs-cTn) criteria in patients presenting with chest discomfort to 26 emergency departments in three

2019 EvidenceUpdates

4. The Effect of PR interval Prolongation on Long term Outcomes in Patients with Left Bundle Branch Block vs. Non-Left Bundle Branch Block Morphologies Undergoing Cardiac Resynchronization Therapy. (Abstract)

The Effect of PR interval Prolongation on Long term Outcomes in Patients with Left Bundle Branch Block vs. Non-Left Bundle Branch Block Morphologies Undergoing Cardiac Resynchronization Therapy. Although the influence of QRS duration (QRSd) and/or bundle branch block morphology on outcomes of cardiac resynchronization therapy (CRT) have been well studied, the effect of PR interval remains uncertain.The purpose of this study was to evaluate the impact of PR prolongation (PRp) before CRT on long (...) -term outcomes, specifically taking into account bundle branch block morphology and QRSd.We extracted clinical data on consecutive patients undergoing CRT. Multivariate models were constructed to analyze the effect of PRp (≥200 ms) on the combined endpoint of death, heart transplant, or left ventricular assist device. Kaplan-Meier curves were constructed stratifying patients based on bundle branch block and QRSd (dichotomized by 150 ms).Of the 472 patients who met inclusion criteria, 197 (41.7%) had

2017 Heart Rhythm

5. Automatic diagnosis of strict left bundle branch block using a wavelet-based approach. Full Text available with Trip Pro

Automatic diagnosis of strict left bundle branch block using a wavelet-based approach. Patients with left bundle branch block (LBBB) are known to have a good clinical response to cardiac resynchronization therapy. However, the high number of false positive diagnosis obtained with the conventional LBBB criteria limits the effectiveness of this therapy, which has yielded to the definition of new stricter criteria. They require prolonged QRS duration, a QS or rS pattern in the QRS complexes

2019 PLoS ONE

6. Intracardiac Delineation of Septal Conduction in Left Bundle Branch Block Patterns: Mechanistic Evidence of Left Intra-Hisian Block Circumvented by His Pacing. Full Text available with Trip Pro

Intracardiac Delineation of Septal Conduction in Left Bundle Branch Block Patterns: Mechanistic Evidence of Left Intra-Hisian Block Circumvented by His Pacing. Septal activation in patients with left bundle branch block patterns has not been previously described. We performed detailed intracardiac mapping of left septal conduction to assess for the presence and level of complete conduction block in the His-Purkinje system. Response to His pacing was assessed in patients with and without (...) complete conduction block in the left bundle.Left septal mapping was performed with a linear multielectrode catheter in consecutive patients with LBBB pattern referred for device implant (n=38) or substrate mapping (n=47). QRS width, His duration, HV intervals, and septal conduction patterns were analyzed. The site of complete conduction block (CCB) was localized to the level of the left-sided His fibers (left intra-hisian) or left bundle branch (LBB). Patients with ventricular activation preceded

2019 Circulation

7. His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block Full Text available with Trip Pro

His-Bundle Pacing in a Patient with Transcatheter Aortic Valve Implantation-Induced Left Bundle Branch Block Transcatheter aortic valve implantation (TAVI) is an effective intervention for severe aortic stenosis in patients at intermediate or high surgical risk, but damage to the native conduction system such as left bundle branch block (LBBB) may offset its benefits. New onset LBBB is associated with a higher risk of cardiovascular morbidity and mortality. His-bundle pacing (HBP) may be useful (...) of the proximal His restored AV synchrony without correction of LBBB. Repositioning of the lead with capture of the left bundle branch enabled complete ventricular resynchronisation with a single lead. Our case demonstrates that LBBB in the setting of TAVI may be corrected by HBP.

2018 Case reports in cardiology

8. Long-term outcomes of His bundle pacing in patients with heart failure with left bundle branch block. (Abstract)

Long-term outcomes of His bundle pacing in patients with heart failure with left bundle branch block. His bundle pacing (HBP) can potentially correct left bundle branch block (LBBB). We aimed to assess the efficacy of HBP to correct LBBB and long-term clinical outcomes with HBP in patients with heart failure (HF).This is an observational study of patients with HF with typical LBBB who were indicated for pacing therapy and were consecutively enrolled from one centre. Permanent HBP leads were

2018 Heart

9. Permanent His Bundle Pacing for Cardiac Resynchronization Therapy in Patients With Heart Failure and Right Bundle Branch Block. Full Text available with Trip Pro

Permanent His Bundle Pacing for Cardiac Resynchronization Therapy in Patients With Heart Failure and Right Bundle Branch Block. Background Cardiac resynchronization therapy utilizing biventricular pacing is an effective therapy for patients with left ventricular (LV) systolic dysfunction, left bundle branch block, and heart failure. Benefits of biventricular pacing may be limited in patients with right bundle branch block (RBBB). Permanent His bundle pacing (HBP) has recently been reported (...) . Results Mean age was 72±10 years, female 15%, with an average LV ejection fraction of 31±10%. HBP was successful in 37 of 39 patients (95%) with narrowing of RBBB in 78% cases. His capture and bundle branch block correction thresholds were 1.1±0.6 V and 1.4±0.7 V at 1 ms, respectively. During a mean follow-up of 15±23 months, there was a significant narrowing of QRS from 158±24 to 127±17 ms ( P=0.0001), increase in LV ejection fraction from 31±10% to 39±13% ( P=0.004), and improvement in New York

2018 Circulation. Arrhythmia and electrophysiology

10. Cardiac resynchronization therapy for rate-related bundle branch block: Is there a role for His-bundle pacing? Full Text available with Trip Pro

Cardiac resynchronization therapy for rate-related bundle branch block: Is there a role for His-bundle pacing? 30364697 2019 02 26 2214-0271 4 10 2018 Oct HeartRhythm case reports HeartRhythm Case Rep Cardiac resynchronization therapy for rate-related bundle branch block: Is there a role for His-bundle pacing? 475-479 10.1016/j.hrcr.2018.07.005 Contractor Tahmeed T Loma Linda University Medical Center, Loma Linda, California. Timothy Pamela P Loma Linda University Medical Center, Loma Linda (...) , California. Pai Sudha S Loma Linda University Medical Center, Loma Linda, California. Mitchell Ingrid I Loma Linda University Medical Center, Loma Linda, California. Bhardwaj Rahul R Loma Linda University Medical Center, Loma Linda, California. Mandapati Ravi R Loma Linda University Medical Center, Loma Linda, California. eng Case Reports 2018 08 30 United States HeartRhythm Case Rep 101656239 2214-0271 Cardiac resynchronization therapy Cardiomyopathy Dyssynchrony His bundle pacing Left bundle branch

2018 HeartRhythm Case Reports

11. Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic induction by landiolol Full Text available with Trip Pro

Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic induction by landiolol 29296582 2019 02 26 2214-0271 3 12 2017 Dec HeartRhythm case reports HeartRhythm Case Rep Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic induction by landiolol. 586-589 10.1016/j.hrcr.2017.09.006 (...) United States HeartRhythm Case Rep 101656239 2214-0271 Catheter ablation Focal ventricular tachycardia Landiolol infusion Right bundle branch 2018 1 4 6 0 2018 1 4 6 0 2018 1 4 6 1 epublish 29296582 10.1016/j.hrcr.2017.09.006 S2214-0271(17)30168-9 PMC5741816 Heart Rhythm. 2008 Jan;5(1):142-4 18055268 Am J Cardiol. 1981 Feb;47(2):315-22 7468483 Europace. 2011 Feb;13(2):292-4 20817939 Circ Arrhythm Electrophysiol. 2014 Dec;7(6):1159-67 25378469 Heart Rhythm. 2013 Aug;10(8):1234-6 22728342 Heart Rhythm

2017 HeartRhythm Case Reports

12. Left bundle branch block in Duchenne muscular dystrophy: Prevalence, genetic relationship and prognosis. Full Text available with Trip Pro

Left bundle branch block in Duchenne muscular dystrophy: Prevalence, genetic relationship and prognosis. Duchenne muscular dystrophy (DMD) is an inherited myogenic disorder due to mutations in the dystrophin gene on chromosome Xp21.1. We designed this study to determine the prevalence of left bundle branch block (LBBB), whether there is a relationship between LBBB and genetic pattern, and to assess predictive factors for acute cardiac events and mortality in adult DMD patients.We reviewed

2018 PLoS ONE

13. Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation Full Text available with Trip Pro

Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation 29915714 2019 02 26 2214-0271 4 5 2018 May HeartRhythm case reports HeartRhythm Case Rep Isolated left bundle branch block progressing to complete heart block and asystole: A novel presentation of a desmin mutation. 184-186 10.1016/j.hrcr.2018.01.011 Gearhart Addison S AS University of California, Irvine, Irvine, California. Batra Anjan S AS University of California (...) , Irvine, Irvine, California. eng Case Reports 2018 03 01 United States HeartRhythm Case Rep 101656239 2214-0271 Complete heart block Desminopathy Left bundle branch block Pacemaker Syncope 2018 6 20 6 0 2018 6 20 6 0 2018 6 20 6 1 epublish 29915714 10.1016/j.hrcr.2018.01.011 S2214-0271(18)30020-4 PMC6003535 Br Heart J. 1980 Feb;43(2):164-9 6444828 J Thorac Cardiovasc Surg. 2012 Dec;144(6):e127-45 23140976 Cardiol Young. 2004 Feb;14(1):68-74 15237674 Neuromuscul Disord. 2012 Mar;22(3):211-8 22153487

2018 HeartRhythm Case Reports

14. Absence of Rapid Propagation through the Purkinje Network as a Potential Cause of Line Block in the Human Heart with Left Bundle Branch Block Full Text available with Trip Pro

Absence of Rapid Propagation through the Purkinje Network as a Potential Cause of Line Block in the Human Heart with Left Bundle Branch Block Background: Cardiac resynchronization therapy is an effective device therapy for heart failure patients with conduction block. However, a problem with this invasive technique is the nearly 30% of non-responders. A number of studies have reported a functional line of block of cardiac excitation propagation in responders. However, this can only be detected (...) using non-contact endocardial mapping. Further, although the line of block is considered a sign of responders to therapy, the mechanism remains unclear. Methods: Herein, we created two patient-specific heart models with conduction block and simulated the propagation of excitation based on a cellmodel of electrophysiology. In one model with a relatively narrow QRS width (176 ms), we modeled the Purkinje network using a thin endocardial layer with rapid conduction. To reproduce a wider QRS complex

2018 Frontiers in physiology

15. Pre-existing Left Bundle Branch Block and Atrial Fib: what is alarming on this routine pre-procedure ECG?

Pre-existing Left Bundle Branch Block and Atrial Fib: what is alarming on this routine pre-procedure ECG? Dr. Smith's ECG Blog: Pre-existing Left Bundle Branch Block and Atrial Fib: what is alarming on this routine pre-procedure ECG? Sunday, January 20, 2019 An elderly patient had a pre-procedure ECG (ECG-1). She was asymptomatic. The patient had known Left Bundle Branch Block (LBBB) and atrial fibrillation (see ECG-2 below), and was rate controlled on metoprolol. ECG-1 What is the problem? ECG (...) causes life threatening dysrhythmias. At exactly what level one is at risk of such dysrhythmia is uncertain, but certainly any K below 2.0 is life threatening. Probably under 2.5 is life threatening. I believe that any hypokalemia that results in ECG abnormalities such as large U-waves, long QT, or ST-T abnormalities is potentially life threatening. There are few reports of AV block due to hypokalemia, but it has been described. It is also rare to see U-waves in the setting of LBBB. Two case reports

2019 Dr Smith's ECG Blog

16. A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB).

A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB). Dr. Smith's ECG Blog: A patient with cardiac arrest, ROSC, and right bundle branch block (RBBB). Thursday, February 28, 2019 A patient arrived after PEA arrest, with ROSC after intubation and chest compressions. Here is the initial 12-lead ECG: What is the appropriate therapy? This ECG is all but diagnostic of hyperkalemia. There is an irregular, slow, wide complex rhythm. Is it ventricular escape? (no, because (...) it is irregular and there appear to be conduced P-waves). Or atrial fib with slow ventricular response? (no, because it is irregular and there appear to be conducted P-waves). Because you can see some conducted atrial activity in lead II across the bottom, you know that it is of supraventricular origin. So then it is clear that there is Right Bundle branch block (RBBB). However, it is extremely wide (the computer measured it at 193 ms, and I think this is correct), much wider than RBBB should be. Also, you

2019 Dr Smith's ECG Blog

17. Diagnosis of right bundle branch block: a concordance study. Full Text available with Trip Pro

Diagnosis of right bundle branch block: a concordance study. Right bundle branch block is one of the most common electrocardiographic abnormalities. Most cases of right bundle branch block are detected in asymptomatic patients in primary care, so a correct interpretation of electrocardiograms (ECGs) at this level is necessary. The objective of this research is to determine the degree of concordance in the diagnosis of incomplete and complete right bundle branch block between four primary care (...) researchers and a cardiologist.The research design is a retrospective cohort study of patients over 18 years of ages of patients over 18 years of ages who underwent an ECG for any reason and were diagnosed with right bundle branch block by their physician. The physicians participating, 4 primary care researchers and a cardiologist were specialized in interpreting electrocardiographic records. The diagnosis of incomplete and complete right bundle branch block was recorded and other secondary variables were

2019 BMC Family Practice

18. Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety and acute effect. Full Text available with Trip Pro

Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety and acute effect. Left bundle branch area pacing (LBBAP), a new pacing approach, lacks adequate evaluation.To assess the feasibility, safety, and acute effect of permanent LBBAP in patients with atrioventricular block (AVB).A total of 33 AVB patients with indications for ventricular pacing were recruited. Electrocardiograms, pacing parameters, echocardiographic measurements and complications associated (...) with LBBAP were evaluated perioperatively and at 3-month follow-up. Successful LBBAP was defined as a paced QRS morphology of right bundle branch block pattern in lead V1 and QRS duration (QRSd) less than 130 ms.LBBAP was successfully performed in 90.9% (30/33) of patients (mean age: 55.1±18.5 years; 66.7% male). The mean capture threshold was similar during the procedure (0.76±0.26 V at 0.4 ms) and at the 3-month follow-up (0.64±0.20 V at 0.4 ms). The paced QRSd was 112.8 ± 10.9 ms during the procedure

2019 Heart Rhythm

19. Left bundle branch block-induced cardiomyopathy: a diagnostic proposal for a poorly explored pathological entity. (Abstract)

Left bundle branch block-induced cardiomyopathy: a diagnostic proposal for a poorly explored pathological entity. Despite being increasingly recognized as a specific disease, at the present time left bundle branch block (LBBB)-induced cardiomyopathy is neither formally included among unclassified cardiomyopathies nor among the acquired/non-genetic forms of dilated cardiomyopathy (DCM). Currently, a post-hoc diagnosis of LBBB-induced cardiomyopathy is possible when evaluating patients' response

2019 International journal of cardiology

20. Long-Term Outcomes in Patients With New-Onset Persistent Left Bundle Branch Block Following TAVR. (Abstract)

Long-Term Outcomes in Patients With New-Onset Persistent Left Bundle Branch Block Following TAVR. The aim of this study was to determine the impact of new-onset persistent (NOP) left bundle branch block (LBBB) on long-term (>2 year) outcomes after transcatheter aortic valve replacement (TAVR).The impact of NOP-LBBB after TAVR remains controversial and no data exist regarding long-term outcomes.A total of 1,020 consecutive patients without pre-existing LBBB or permanent pacemaker implantation

2019 JACC. Cardiovascular interventions

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