Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block
Abstract Aims The left bundle branch block (LBBB) is a strong predictor of response to cardiac resynchronization therapy (CRT). However, a significant number of patients do not respond to the treatment. The study sought to evaluate the impact of the stricter Strauss criteria for left bundle branch b...
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Wiley
2025-02-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15028 |
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| author | Athanasios Saplaouras Konstantinos Vlachos Panagiotis Mililis Athena Batsouli George Bazoukis Sotirios Xydonas Panagioula Niarchou Antonio Frontera Stylianos Dragasis Ourania Kariki Ilias G. Patsiotis Aggeliki Gkouziouta Panagiotis Stachteas Panagiotis Korantzopoulos Stylianos Tzeis Nikolaos Fragakis Michael Efremidis Konstantinos P. Letsas |
| author_facet | Athanasios Saplaouras Konstantinos Vlachos Panagiotis Mililis Athena Batsouli George Bazoukis Sotirios Xydonas Panagioula Niarchou Antonio Frontera Stylianos Dragasis Ourania Kariki Ilias G. Patsiotis Aggeliki Gkouziouta Panagiotis Stachteas Panagiotis Korantzopoulos Stylianos Tzeis Nikolaos Fragakis Michael Efremidis Konstantinos P. Letsas |
| author_sort | Athanasios Saplaouras |
| collection | DOAJ |
| description | Abstract Aims The left bundle branch block (LBBB) is a strong predictor of response to cardiac resynchronization therapy (CRT). However, a significant number of patients do not respond to the treatment. The study sought to evaluate the impact of the stricter Strauss criteria for left bundle branch block (St‐LBBB) on CRT response, hospitalizations, ventricular arrhythmia (VA) events and mortality. Methods This study is a retrospective analysis of prospectively collected data on heart failure (HF) patients with LBBB admitted for CRT implantation. Patients were divided into two groups according to the fulfilment or not of St‐LBBB criteria. Results The study included 82 patients with ischaemic (ICM) and non‐ischaemic (NICM) cardiomyopathy [46 (56%) with St‐LBBB and 36 (44%) with non‐St‐LBBB]. Patients with St‐LBBB showed higher CRT response rates compared with those with non‐St‐LBBB (P < 0.01), while the group with NICM exhibited the greatest benefit (P < 0.01). St‐LBBB CRT responders displayed significantly lower rates of HF hospitalization (P < 0.0001) compared with the non‐St‐LBBB group. According to Kaplan–Meier time curves, this was primarily evident in patients with NICM (P < 0.0001). CRT responders displayed significantly fewer VA events (P < 0.001) and lower mortality rates (P < 0.0001) than non‐responders. Kaplan–Meier estimates demonstrated a significantly lower incidence of VAs in NICM patients with St‐LBBB (P = 0.049) compared with ICM patients with St‐LBBB (P = 0.25). Lower mortality rates were observed in CRT responders than non‐responders (P < 0.0001), with the group of NICM with St‐LBBB criteria exhibiting the greatest benefit (P = 0.0238). Conclusions Patients with NICM and St‐LBBB present the greatest benefit concerning CRT response, HF hospitalizations, VA events and mortality. Although St‐LBBB criteria seem to improve patient selection for CRT, more data are needed to elucidate the role of St‐LBBB criteria in this setting. |
| format | Article |
| id | doaj-art-a6d8aab5f7e64f9e90f94e5ae9b53d61 |
| institution | OA Journals |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-a6d8aab5f7e64f9e90f94e5ae9b53d612025-08-20T02:16:21ZengWileyESC Heart Failure2055-58222025-02-0112117418410.1002/ehf2.15028Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch blockAthanasios Saplaouras0Konstantinos Vlachos1Panagiotis Mililis2Athena Batsouli3George Bazoukis4Sotirios Xydonas5Panagioula Niarchou6Antonio Frontera7Stylianos Dragasis8Ourania Kariki9Ilias G. Patsiotis10Aggeliki Gkouziouta11Panagiotis Stachteas12Panagiotis Korantzopoulos13Stylianos Tzeis14Nikolaos Fragakis15Michael Efremidis16Konstantinos P. Letsas17Arrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceDepartment of Cardiology Evangelismos General Hospital Athens GreeceDepartment of Cardiology Larnaca General Hospital Larnaca CyprusDepartment of Cardiology Evangelismos General Hospital Athens GreeceDepartment of Cardiology Evangelismos General Hospital Athens GreeceDepartment of Cardiac Pacing and Electrophysiology Hôpital Cardiologique du Haut Lévêque Pessac Cedex FranceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens Greece3rd Department of Cardiology Hippokration University Hospital, Aristotle University of Thessaloniki Thessaloniki GreeceDepartment of Cardiology University Hospital of Ioannina Ioannina GreeceDepartment of Cardiology Mitera Hospital Marousi Greece3rd Department of Cardiology Hippokration University Hospital, Aristotle University of Thessaloniki Thessaloniki GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceArrhythmia Unit Onassis Cardiac Surgery Center Athens GreeceAbstract Aims The left bundle branch block (LBBB) is a strong predictor of response to cardiac resynchronization therapy (CRT). However, a significant number of patients do not respond to the treatment. The study sought to evaluate the impact of the stricter Strauss criteria for left bundle branch block (St‐LBBB) on CRT response, hospitalizations, ventricular arrhythmia (VA) events and mortality. Methods This study is a retrospective analysis of prospectively collected data on heart failure (HF) patients with LBBB admitted for CRT implantation. Patients were divided into two groups according to the fulfilment or not of St‐LBBB criteria. Results The study included 82 patients with ischaemic (ICM) and non‐ischaemic (NICM) cardiomyopathy [46 (56%) with St‐LBBB and 36 (44%) with non‐St‐LBBB]. Patients with St‐LBBB showed higher CRT response rates compared with those with non‐St‐LBBB (P < 0.01), while the group with NICM exhibited the greatest benefit (P < 0.01). St‐LBBB CRT responders displayed significantly lower rates of HF hospitalization (P < 0.0001) compared with the non‐St‐LBBB group. According to Kaplan–Meier time curves, this was primarily evident in patients with NICM (P < 0.0001). CRT responders displayed significantly fewer VA events (P < 0.001) and lower mortality rates (P < 0.0001) than non‐responders. Kaplan–Meier estimates demonstrated a significantly lower incidence of VAs in NICM patients with St‐LBBB (P = 0.049) compared with ICM patients with St‐LBBB (P = 0.25). Lower mortality rates were observed in CRT responders than non‐responders (P < 0.0001), with the group of NICM with St‐LBBB criteria exhibiting the greatest benefit (P = 0.0238). Conclusions Patients with NICM and St‐LBBB present the greatest benefit concerning CRT response, HF hospitalizations, VA events and mortality. Although St‐LBBB criteria seem to improve patient selection for CRT, more data are needed to elucidate the role of St‐LBBB criteria in this setting.https://doi.org/10.1002/ehf2.15028CRT responseischaemic cardiomyopathynon‐ischaemic cardiomyopathyStrauss LBBBventricular arrhythmias |
| spellingShingle | Athanasios Saplaouras Konstantinos Vlachos Panagiotis Mililis Athena Batsouli George Bazoukis Sotirios Xydonas Panagioula Niarchou Antonio Frontera Stylianos Dragasis Ourania Kariki Ilias G. Patsiotis Aggeliki Gkouziouta Panagiotis Stachteas Panagiotis Korantzopoulos Stylianos Tzeis Nikolaos Fragakis Michael Efremidis Konstantinos P. Letsas Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block ESC Heart Failure CRT response ischaemic cardiomyopathy non‐ischaemic cardiomyopathy Strauss LBBB ventricular arrhythmias |
| title | Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block |
| title_full | Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block |
| title_fullStr | Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block |
| title_full_unstemmed | Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block |
| title_short | Cardiac resynchronization therapy in heart failure based on Strauss criteria for left bundle branch block |
| title_sort | cardiac resynchronization therapy in heart failure based on strauss criteria for left bundle branch block |
| topic | CRT response ischaemic cardiomyopathy non‐ischaemic cardiomyopathy Strauss LBBB ventricular arrhythmias |
| url | https://doi.org/10.1002/ehf2.15028 |
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