{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:59:33Z","timestamp":1740153573802,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T00:00:00Z","timestamp":1545264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Conventional complete left bundle branch block (<jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content>) criteria sometimes result in a false\u2010positive diagnosis that does not represent dyssynchrony. Recently, true <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> criteria have been proposed to detect responders to cardiac resynchronization therapy (<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>), although their correlation with severity of dyssynchrony or natural prognosis is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety\u2010four consecutive patients (74\u00a0\u00b1\u00a09\u00a0years, 63 men) with conventional <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> during sinus rhythm underwent semiconductor <jats:styled-content style=\"fixed-case\">SPECT<\/jats:styled-content>. They were divided into two groups: patients with true <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> and others. True <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> was characterized by the mid\u2010<jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content> notching\/slurring and wide <jats:styled-content style=\"fixed-case\">QRS<\/jats:styled-content> duration (male, \u2265140\u00a0milliseconds; female, \u2265130\u00a0milliseconds). Multivariate analysis was performed to detect left ventricular dyssynchrony (<jats:styled-content style=\"fixed-case\">LVD<\/jats:styled-content>), defined as bandwidth \u2265145\u00b0 and\/or phase standard deviation (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) \u226543\u00b0. Primary endpoints (hospitalization for heart failure or cardiac death) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>True <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> had wider bandwidth (145\u00a0\u00b1\u00a083\u00b0 vs 110\u00a0\u00b1\u00a064\u00b0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.024) and higher phase <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> (48\u00a0\u00b1\u00a026\u00b0 vs 35\u00a0\u00b1\u00a019\u00b0, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). Ejection fraction (<jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>), end\u2010diastolic volume (<jats:styled-content style=\"fixed-case\">EDV<\/jats:styled-content>), summed rest score (<jats:styled-content style=\"fixed-case\">SRS<\/jats:styled-content>), and the presence of ischemic heart disease (<jats:styled-content style=\"fixed-case\">IHD<\/jats:styled-content>) showed no differences between groups (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.401, 0.591, 0.165, and 0.212, respectively). Multivariate analysis revealed that true <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EF<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">EDV<\/jats:styled-content> were significant predictors of <jats:styled-content style=\"fixed-case\">LVD<\/jats:styled-content> (odds ratio, 12.6, 0.90, 1.03; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003, 0.002, 0.022, respectively). At 3\u2010year follow\u2010up (median 667\u00a0days), primary endpoints were comparable in both groups (log\u2010rank, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.92).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with true <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content> had more severe dyssynchrony on single\u2010photon emission computed tomography than patients with nontrue <jats:styled-content style=\"fixed-case\">CLBBB<\/jats:styled-content>. On the other hand, the two groups showed no differences in <jats:styled-content style=\"fixed-case\">EF<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EDV<\/jats:styled-content>, the presence of <jats:styled-content style=\"fixed-case\">IHD<\/jats:styled-content>, hospitalization for heart failure, and cardiac death.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12148","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T14:09:57Z","timestamp":1545314997000},"page":"70-78","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["True complete left bundle branch block reveals dyssynchrony evaluated by semiconductor single\u2010photon emission computed tomography"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4618-5261","authenticated-orcid":false,"given":"Munehiro","family":"Iiya","sequence":"first","affiliation":[{"name":"Department 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