Echocardiographic assessment of inter and intra ventricular dyssynchrony in heart failure patients with normal QRS duration
Journal Title: MedPulse -International Medical Journal - Year 2018, Vol 5, Issue 10
Abstract
Background: Cardiac resynchronization therapy can improve cardiac function and clinical status in patients with severe heart failure and left bundle branch block. Since in initial studies patients with a wide QRS seemed to benefit the most from biventricular pacing, most of the patients enrolled in these trials had a QRS duration greater than 150 ms. Aim: To assess the prevalence of inter and intraventricular dyssynchrony in heart patients with normal QRS duration irrespective of the etiology. Methods: All heart failure patients with ejection fraction less than 35% and narrow QRS (less than 120 milliseconds) with duration of symptoms 6 months or more irrespective of the etiology were included in the study. All patients underwent detailed Echocardiographic evaluation. The echocardiogram was performed using PHILIPS HD7XE machine. Results: Dyssynchrony can be present in severe heart failure. 30 heart failure patients with ejection fraction less than 35% and narrow QRS (less than 120 milliseconds) with duration of symptoms 6 months or more were assessed by detailed Echocardiographic evaluation. Interventricular dyssynchrony was present in 20% of the patients The frequency of intraventricular dyssynchrony in this study was 23.3% based on Ts SD and Ts diff. Among the indices, the correlation between Ts –SD and Ts diff was greater. Intra and interventricular dyssynchrony occur in a significant proportion of heart failure patients with a QRS duration of 120 ms or less. Conclusion: Cardiac resynchronization therapy can improve cardiac function and clinical status in patients with severe heart failure and left bundle branch block. Since in initial studies patients with a wide QRS seemed to benefit the most from biventricular pacing, most of the patients enrolled in these trials had a QRS duration greater than 150ms.
Authors and Affiliations
Viswanathan T, Balachandran C, Ravichandran Edwin M, A S Arul, Anandan Heber
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