Analysis Of The Therapeutic Effect Of Different Forms Of Left Bundle Branch Block On Cardiac Resynchronization

Objective: To retrospectively investigate the prognosis of patients undergoing cardiac resynchronization therapy(CRT)in patients with true or non-true related conduction block and heart failure.Methods: Thirty-one patients with chronic heart failure who underwent CRT-P/D treatment at the Jijijishan Hospital of the First Affiliated Hospital of Wannan Medical College from December 2014 to December 2018 were enrolled.According to the electrocardiogram of the pre-implantation body surface,it was divided into true left bundle branch block(t-LBBB,20 cases):(1)V1,V2 lead QRS wave negative wave dominated(present QS waveform or rS wave)),and r wave <0.1 mV,aV lead q wave <0.1 mV;(2)the lowest 2 corresponding waves in the lead show a setback or notch.(3)The wave time is only≥140 ms for male patients and≥130 ms for females.Non-authentic block group(10): In combination with electrocardiogram,we believe that the patient’s condition meets the concept of typical left bundle branch block,but it does not really meet the requirements of true disease.The general clinical data of the 2groups of patients,echocardiography of the patient at 6 months after follow-up[including left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],New York Heart Association(NYHA)heart The changes in indicators such as functional grading were analyzed to compare the prognosis of patients undergoing cardiac resynchronization therapy.Results: There were no significant differences in age,gender,hypertension,diabetes,atrial fibrillation,and postoperative medication between the two groups(P>0.05).The LVEF,LVEDD,and QRS time limits were significantly improved at the last follow-up of the two groups compared with those before surgery(P<0.05).The degree of elevation of LVEF(ΔLVEF)was significantly higher in the t-CLBBB group[(19.95±7.90%)] than in the nt-CLBBB group [(8.91±6.33)%](P < 0.001).Similarly,in the improvement of LVEDD(ΔLVEDD),the nt-LBBB group [(-11.00±2.93)mm] was also significantly less in the t-LBBB group [(-19.95±7.29)mm](P < 0.05).The QRS durations of the two groups were shortened before and after surgery,and the true group was shorter than the non-authentic group(P=0.020).As of the end of the last follow-up,the response rate was 90.0% in the true group and 5(45.5%)in the non-authentic group.The difference was statistically significant(P < 0.050).Similarly,the number of non-responders in the true group was 2(10.0%),and the number of non-responders in the non-authentic group was 6(54.5%).There was also a statistically significant difference between the two groups(P<0.05).The patients with reaction in the 2 groups were compared.Compared with the corresponding non-authentic group,the LVEF and LVEDD before and after the operation were more obvious than the latter.There were statistical values of preoperative and postoperative changes of LVEF and LVEDD(P<0.050).Aiming at the response of the implanted patients,the regression analysis of the main related factors such as preoperative and postoperative reactivity was made,and the true left bundle branch block was the predictor of postoperative reaction(trusted area: 1.23).-80.09,P < 0.05),see Table 5.Conclusion: Cardiac resynchronization therapy is an effective treatment for chronic heart failure;patients with different subtypes of left bundle branch block heart failure have different clinical responsiveness to CRT;t-LBBB(true left bundle branch block)responds after CRT Independent predictors;patients with heart failure who have a true definition of true left bundle branch block are more likely to benefit from CRT.