Cardiodynamic effects of experimental right bundle branch block in canine hearts with normal and hypertrophied right ventricles

Yasui, Hirofumi; M, Yoshitoshi; Komori, Motofumi; Tominaga, Ryuji; Kawachi, Yoshito; Ueno, Yasutaka; Saito, Hiroshi; Tokunaga, Kazutoshi

doi:10.1016/0002-8703(85)90417-x

Cited by 8 publications

(12 citation statements)

References 27 publications

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“…This deterioration was related to the duration of the QRS complex. 30 In this model, Lv function was hardly affected. These data are important because they indicate that RBBB may affect Rv function, the forgotten ventricle; however, few data are available on Rv systolic function in patients with heart failure, alone or in combination with RBBB, LBBB, and CRT.…”

Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 81%

“…28,29 In this regard, less is known about the hemodynamic effect of RBBB. In the 1980s, yasui et al 30 induced experimental RBBB in dogs with normal hearts and in dogs with moderate and severe Rv hypertrophy. They found minor influence of RBBB on Rv and Lv pump function in normal hearts, but significant deterioration if occurring in hearts with Rv hypertrophy: RBBB increased Rv end-diastolic pressure, Rv dP/dtmax, and stroke volume.…”

Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 99%

“…These data are important because they indicate that RBBB may affect Rv function, the forgotten ventricle; however, few data are available on Rv systolic function in patients with heart failure, alone or in combination with RBBB, LBBB, and CRT. However, it is important to notice that Rv hypertrophy is rarely observed in adults patients with systolic heart failure; therefore, it makes it difficult to completely translate in patients the observation by yasui et al 30 Byrne et al 31 investigated mechanical dyssynchrony in a canine model of RBBB and LBBB in combination with tachypacing-induced heart failure. With LBBB, there was a septal shortening and lateral stretch during early systole followed by septal stretch and lateral shortening later in systole.…”

Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 99%

“…V 80. letech 20. století Yasui a spol. 30 indukovali experimentální BPRT u psů s normál-ním srdcem a psů se středně těžkou a těžkou hypertrofi í PK. U psů s normálním srdcem měla BPRT jen malý dopad na funkci PK a LK jako pumpy, ale k významnému zhorše-ní došlo u psů s hypertrofi í PK.…”

Section: Mechanické Abnormality Pk a Lk U Zvířat A Nemocných S Bprtunclassified

“…To bylo závislé na šíři komplexu QRS. 30 Funkce LK však nebyla v tomto modelu téměř vůbec ovlivněna. Tato data jsou důležitá, protože ukazují, že BPRT může ovlivnit funkci PK, na kterou se často zapomíná.…”

Section: Mechanické Abnormality Pk a Lk U Zvířat A Nemocných S Bprtunclassified

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Does Cardiac Resynchronization Therapy Benefit Patients With Right Bundle Branch Block

Auricchio

Lumens

Prinzen

2014

Circ: Arrhythmia and Electrophysiology

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C ardiac resynchronization therapy (CRT) has been established as a useful therapy for patients with heart failure with abnormal QRS duration and low ejection fraction (EF). Although the vast majority of patients treated with CRT have a left bundle branch block (LBBB) QRS morphology, since the introduction of CRT into clinical practice, a growing number of patients with right bundle branch block (RBBB) QRS morphology or diffuse intraventricular conduction abnormality have been treated. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] As shown in Table 1, the most recently conducted studies report a variable proportion of patients with RBBB ≤18%. Thus, these patients represent a sizeable subgroup in need of adjunct therapies on top of the best pharmacological therapy. This percentage is most likely an underestimation of the true number of patients with heart failure and RBBB, because CRT in patients with RBBB has been controversial from the beginning, although QRS widening ≥120 ms was the only ECG selection criterion for CRT. More recently, several studies have shown that non-LBBB patients benefit less from CRT than those with LBBB.20,21 As a consequence, European Society of Cardiology guidelines indicate the use of CRT in non-LBBB patients with a QRS duration >150 ms at class IIa/level of evidence B, whereas guidelines suggest the use of CRT in non-LBBB patients with a QRS duration between 120 and 150 ms at a lower recommendation class (class IIb, level of evidence B). 22 Response by Kenneth Bilchick on p 542Although several factors may be held accountable for the diverse response to CRT in RBBB compared with LBBB, they have not been systematically reviewed. However, several retrospectively conducted studies have suggested that CRT may be beneficial in subgroups of patients with RBBB. In the present article, we are taking a mechanistic approach to evaluate the effect of CRT in patients with heart failure diagnosed with RBBB. Thus, we will review the electrophysiological findings, the mechanical abnormalities observed in patients with RBBB, and finally the clinical results of CRT in this patient subgroup to address a key question: is RBBB an inappropriate indication for CRT or is CRT applied in the wrong way in patients with RBBB? Right and Left Ventricular Electric Activation in Patients With RBBBThe relative fragility and mechanical structure of the rightsided conduction system may explain the high incidence of this conduction delay in the general population without evidence of structural heart disease. In the Framingham study, RBBB and LBBB developed in 70 and 55 patients, respectively, during 18-year follow-up in 5826 healthy individuals. 23The Moli-sani study, which recruited 24 090 subjects in the central-southern region of Italy, 24 reported that RBBB was recorded in 589 individuals (2.44%), whereas LBBB was recorded in 181 individuals (0.75%); interestingly, RBBB was more frequent in men (3.4%) than in women (1.0%), whereas LBBB was slightly more frequent in women (0.9%) than in (Circ Ar...

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Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 81%

Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 99%

Section: Rv and LV Mechanical Abnormalities In Animals And Patients Wmentioning

confidence: 99%

Section: Mechanické Abnormality Pk a Lk U Zvířat A Nemocných S Bprtunclassified

See 3 more Smart Citations

Does Cardiac Resynchronization Therapy Benefit Patients With Right Bundle Branch Block

Auricchio

Lumens

Prinzen

2014

Circ: Arrhythmia and Electrophysiology

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OBSOLETE: Adverse Impact of Delayed Electrical Activation of the Heart and Benefits of Cardiac Resynchronization

Guha

Daoud

2018

Reference Module in Biomedical Sciences

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Adverse Impact of Delayed Electrical Activation of the Heart and Benefits of Cardiac Resynchronization

Guha¹,

Daoud²

2018

Encyclopedia of Cardiovascular Research and Medicine

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Cardiodynamic effects of experimental right bundle branch block in canine hearts with normal and hypertrophied right ventricles

Cited by 8 publications

References 27 publications

Does Cardiac Resynchronization Therapy Benefit Patients With Right Bundle Branch Block

Does Cardiac Resynchronization Therapy Benefit Patients With Right Bundle Branch Block

OBSOLETE: Adverse Impact of Delayed Electrical Activation of the Heart and Benefits of Cardiac Resynchronization

Adverse Impact of Delayed Electrical Activation of the Heart and Benefits of Cardiac Resynchronization

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