The Non-LBBB Wide QRS Complex Electrocardiogram (ECG) Criteria Furthermore, we conferred the current guidelines, including the comprehensive update of the Canadian Cardiovascular Society (CCS) guidelines for the management of heart failure (HF) 2017, the European Society of Cardiology (ESC) Heart Failure Association guidelines for the diagnosis and treatment of acute and chronic HF 2016, the National Institute of Health and Care Excellence (NICE) guidelines for ICD (implantable cardioverter defibrillator) and CRT for arrhythmia and heart failure 2014, the American College of Cardiology Foundation/American Heart Association guideline for the management of heart failure 2013, the ESC European Heart Rhythm Association guidelines on cardiac pacing and cardiac resynchronisation therapy 2013, and the update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines for the prevention, detection and management of chronic HF in Australia 2011. In this article, we reviewed the major trials that enriched the most recent international guidelines for CRT implantation focusing on the available data about the outcome of using CRT in non-LBBB cohort. It remains uncertain whether patients with non-LBBB QRS complex morphology clearly benefit from CRT or only modestly respond. An important and consistent finding in published systematic reviews and in subgroup analyses is that the benefits of CRTs are maximum for patients with a broader QRS durations, typically described as QRS duration > 150 ms, and for patients with a typical left bundle branch block (LBBB) QRS morphology. Keywords: Non-LBBB RBBB Typical LBBB HFrEF: Cardiac resynchronization therapy QRS duration IntroductionĬardiac resynchronization therapy (CRT) benefits have been firmly established in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), who remain in New York Heart Association (NYHA) functional classes II and III despite optimal medical therapy, and have a wide QRS complex. ![]() An important and consistent finding in published systematic reviews and in subgroup analyses is that the benefits of CRT are maximum for patients with a broader QRS durations, typically described as QRS duration > 150 ms, and for patients with a typical left bundle branch block (LBBB) QRS morphology. Cardiac resynchronization therapy (CRT) benefits have been firmly established in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), who remain in New York Heart Association (NYHA) functional classes II and III, despite optimal medical therapy, and have a wide QRS complex.
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