Analysis of influencing factors of no response to cardiac resynchronization therapy in patients with left bundle branch block and heart failure
Ji Rongjing
Zhao Yonghui
Zhang Jing
Wang Xianqing
Ma Jifang
Song Weifeng
Zang Xiaobiao
Abstract：Objective To analyze the influencing factors of no response to cardiac resynchronization therapy in patients with left bundle branch block (LBBB) and heart failure, and to provide a theoretical basis for clinical improvement of cardiac resynchronization (CRT) therapy in LBBB patients with heart failure. Methods 21 patients with LBBB who underwent CRT (Study group) in Henan Provincial People's Hospital from March 2013 to December 2017 and 40 responders (control group) in the same period were enrolled. Detailed data of two groups was collected and univariate analysis and independent risk factors analysis was conducted. Results Univariate analysis showed that QRS duration, brain natriuretic peptide level, left atrial volume, left ventricular volume, right atrial volume, pacing position, mitral regurgitation, atrial fibrillation and hypertension was significantly correlated with non-response of patients with LBBB and heart failure after CRT (P＜0.05). Independent risk factors analysis showed that QRS duration, pacing position, mitral regurgitation, atrial fibrillation and hypertension was independent risk factors for poor curative effect (P＜0.05). Conclusion QRS duration, pacing position of left ventricular electrode, mitral regurgitation and atrial fibrillation is risk factor for non-response of patients with LBBB and heart failure after CRT. Preoperative optimization of patient selection, intraoperative optimization of left ventricular pacing position, combined with optimal control of postoperative pacing parameters, can improve the response rate of CRT, reduce the cost-effectiveness ratio.
Keywords：Left bundle branch blockHeart failureCardiac resynchronizationNon-responseInfluencing factors
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 537-540 )