{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:55:01Z","timestamp":1778817301296,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,2,23]],"date-time":"2010-02-23T00:00:00Z","timestamp":1266883200000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The current recommendation for cardiac resynchronization therapy (CRT) in congestive heart failure (CHF) patients is based on QRS duration, not on QRS morphology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>This study was performed to compare the effects of CRT in CHF patients with pure RBBB vs those with a coexisting left hemiblock (LHB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Patient Population<\/jats:title><jats:p>A total of 271 consecutive patients who underwent CRT at Montefiore Medical Center were analyzed. Baseline ECGs were analyzed by 2 reviewers for RBBB and further classified into those with a coexisting LHB. Response to CRT was defined to be, at \u2265 6 months after CRT, either an improvement in ejection fraction (EF) of at least 5%, or an improvement in New York Heart Association (NYHA) CHF class. A total of 44 patients were identified: 18 had pure RBBB and 26 had a coexisting LHB. The 2 groups were similar in respect to baseline characteristics (<jats:italic>P<\/jats:italic> &gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only 4 out of 18 patients with pure RBBB compared to 18 out of 26 with LHB (<jats:italic>P<\/jats:italic> = 0.005) had an improvement in EF \u2265 5%. The mean EF was \u2212 1% in the pure RBBB group, but + 5.4% in those with LHB (<jats:italic>P<\/jats:italic> = 0.0031). Improvement in NYHA class was seen in 0 out of 18 with pure RBBB vs 7 out of 26 patients with LHB (<jats:italic>P<\/jats:italic> = 0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>If patients with RBBB also had LHB, their response to CRT was significantly better than if they had RBBB alone. 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