![]() ![]() However, until more data are available it is too early to change guidelines.Ĭopyright © 2011 Heart Rhythm Society. Physicians and patients should be aware of the likely reduced benefit form CRT in patients with RBBB, and this should be factored into decision making. ![]() Results of the meta-analysis can direct further research, perhaps indicating a need for randomized trials in RBBB. A meta-analysis of RBBB patients from the major CRT trials is urgently needed. None of the available data showed more favorable outcomes with CRT in patients with RBBB. None of the available data showed more favorable outcomes (soft or hard) in patients with CRT. Little is known about the response to CRT in patients with right bundle branch block (RBBB) or non-specific intraventricular conduction delay (IVCD). Four publications from five studies reported data on patients with RBBB and were included in this investigation, with 259 patients randomized to CRT and 226 randomized to non-CRT. Randomized controlled trials of CRT in heart failure and left ventricular systolic dysfunction were identified from MEDLINE (1950-2010), EMBASE (1980-2010, week 45), Cochrane Controlled Trials Register (2009), Cochrane Database of Systematic Reviews, National Institutes of Health Clinical database.Ī total of 112 references were retrieved. In patients with a QRSD of 150 to 179 ms, overall survival with CRT-D versus the matched ICD controls was similar for both patients with an IVCD (HR 1.10, 95 CI 0.94 to 1.28) and those with RBBB (HR 0.95, 95 CI 0.79 to 1.13), as shown in the forest plot in the Central Illustration, Panel B. The purpose of this study was to systematically review the published data from randomized clinical trials of CRT on the outcomes in patients with baseline RBBB. Whether patients with right bundle branch block (RBBB) benefit from cardiac resynchronization therapy (CRT) is unclear. ENHANCE CRTs non-LBBB patients had RBBB or an intraventricular conduction delay (IVCD). ![]()
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