title: Cardiac resynchronization in severe heart failure and left bundle branch block: a single center experience.
abstract: OBJECTIVE
  To assess the feasibility and longterm outcome of cardiac resynchronization therapy (CRT) in patients with impaired left ventricular function (LVEF <35%), left bundle branch block (QRS >120 ms) and dyspnoea NYHA 0 III at a single centre.
  
  
  RESULTS
  Forty-seven patients were referred for implantation of a CRT device. In only 4 patients (9%) the device could not be implanted due to technical problems during the procedure. In the remaining 43 patients (65 +/- 10 years; 7 female) a CRT device was implanted. Follow-up time was 12 +/- 10 months. Twenty-one patients had dilated cardiomyopathy (DCM) and 22 patients had coronary artery disease (CAD). NYHA functional class improved from 3.0 +/- 1.4 to 2.5 +/- 0.7 (p <0.0001), accompanied by an improvement of LVEF [median 20% (range 15-25) vs 32% (range 20-40); p <0.0001]. A significant reduction of hospitalisation time for heart failure was found when the year before and the year after device implantation [18 days (range 5-27) vs 1 day (range 0-3); p <0.0001] were compared. Twelve (28%) patients, 9 with CAD, and 3 with DCM died. Two CAD patients and all patients with DCM who died had a combined CRT device with implantable cardioverter/defibrillator.
  
  
  CONCLUSIONS
  In patients with severely impaired LVEF and wide QRS due to LBBB, CRT is feasible and safe. It improved dyspnoea and LVEF and reduced hospitalisation stays for heart failure during long-term follow-up.
authors.affiliation: Department of Cardiology, University Hospital Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Ammann
authors.forename: Stephanie
authors.initials: S
authors.lastname: Kiencke
authors.forename: Beat
authors.initials: B
authors.lastname: Schaer
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Cron
authors.forename: Christian
authors.initials: C
authors.lastname: Sticherling
authors.forename: Christine
authors.initials: C
authors.lastname: Huldi
authors.forename: Andre
authors.initials: A
authors.lastname: Linka
authors.forename: Peter
authors.initials: P
authors.lastname: Buser
authors.forename: Mathias
authors.initials: M
authors.lastname: Pfisterer
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
mesh_terms: D000368:Aged; D002037:Bundle-Branch Block / Q000628:therapy*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D018487:Ventricular Dysfunction, Left / Q000628:therapy*