Left Ventricular Asynchrony in Patients with Right Bundle Branch Block and Normal Ejection Fraction
Article first published online: 4 NOV 2012
©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 36, Issue 1, pages 63–68, January 2013
How to Cite
STEGEMANN, B., DREGER, H., ISMER, B., BAUMANN, G. and MELZER, C. (2013), Left Ventricular Asynchrony in Patients with Right Bundle Branch Block and Normal Ejection Fraction. Pacing and Clinical Electrophysiology, 36: 63–68. doi: 10.1111/pace.12043
- Issue published online: 9 JAN 2013
- Article first published online: 4 NOV 2012
- Manuscript Accepted: 22 SEP 2012
- Manuscript Revised: 13 SEP 2012
- Manuscript Received: 19 JUN 2011
- left ventricular asynchrony;
- left bundle branch block;
- right bundle branch block;
- cardiac resynchronization therapy
The role of right bundle branch block (RBBB) for the induction of left ventricular (LV) asynchrony is discussed controversially. The objective of this study was to assess presence and degree of LV asynchrony in patients with RBBB, left bundle branch block (LBBB), or left anterior hemiblock (LAH) and normal LV function.
We included 15 patients with RBBB, 13 patients with RBBB and concomitant LAH, 10 patients with pure LBBB, and 100 healthy controls into this study. All patients had normal LV function. Interventricular asynchrony was assessed as the difference of the right and LV ejection delay. Intraventricular delay was obtained by tissue synchronicity imaging-guided tissue Doppler imaging measurement.
Interventricular and left intraventricular asynchrony were linked to the presence of an LBBB. No left intraventricular asynchrony was noted during pure RBBB; interventricular delays were negative (aortic flow preceding pulmonary flow) in the presence of RBBB.
In patients with normal LV function, intraventricular asynchrony depends on the presence of an LBBB and interventricular asynchrony is inversed in the presence of RBBB.
(PACE 2013; 36:63–68)