{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:20:12Z","timestamp":1785550812717,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T00:00:00Z","timestamp":1513555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2018,7]]},"abstract":"Background<\/jats:title>Current guidelines select patients for cardiac resynchronization therapy (CRT<\/jats:styled-content>) mainly on electrocardiographic parameters like QRS<\/jats:styled-content> duration and left bundle branch block (LBBB<\/jats:styled-content>). However, among those LBBB<\/jats:styled-content> patients, heterogeneity in mechanical dyssynchrony occurs and might be a reason for nonresponse to CRT<\/jats:styled-content>. This study assesses the relation between electrocardiographic characteristics and presence of mechanical dyssynchrony among LBBB<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>The study included patients with true LBBB<\/jats:styled-content> (including mid\u2010QRS<\/jats:styled-content> notching) on standard 12\u2010lead electrocardiograms. Left bundle branch block\u2010induced mechanical dyssynchrony was assessed by the presence of septal flash on two\u2010dimensional echocardiography. Previously reported electro\u2010 and vectorcardiographic dyssynchrony markers were analyzed: global QRS<\/jats:styled-content> duration (QRSDLBBB<\/jats:sub><\/jats:styled-content>), left ventricular activation time (QRSDLVAT<\/jats:sub><\/jats:styled-content>), time to intrinsicoid deflection (QRSDID<\/jats:sub><\/jats:styled-content>), and vectorcardiographic QRS<\/jats:styled-content> areas in the 3D vector loop (QRSA<\/jats:styled-content>3D<\/jats:sub>).<\/jats:p><\/jats:sec>Results<\/jats:title>The study enrolled 545 LBBB<\/jats:styled-content> patients. Septal flash (SF) is present in 52% of patients presenting with true LBBB<\/jats:styled-content>. Patients with SF<\/jats:styled-content> are more frequent female, have less ischemic heart disease and smaller left ventricular dimensions. In multivariate analysis longer QRSDLBBB<\/jats:sub><\/jats:styled-content>, QRSDLVAT<\/jats:sub><\/jats:styled-content> and larger QRSA<\/jats:styled-content>3D<\/jats:sub> were independently associated with SF<\/jats:styled-content>. Of all parameters, QRSA<\/jats:styled-content>3D<\/jats:sub> has the best accuracy to predict SF<\/jats:styled-content>, although overall accuracy remains moderate (59% sensitivity, 58% specificity). The predictive value of QRSA<\/jats:styled-content>3D<\/jats:sub> remained constant in both sexes, irrespective of ischemic heart disease, ejection fraction and even when categorizing for QRSDLBBB<\/jats:sub><\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In LBBB<\/jats:styled-content> patients, large QRS<\/jats:styled-content> areas correlate better with mechanical dyssynchrony compared to wide QRSD<\/jats:styled-content> intervals. However, the overall accuracy to predict mechanical dyssynchrony by electrocardiographic dyssynchrony markers, even when using complex vectorcardiographic parameters, remains low.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12525","type":"journal-article","created":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T12:53:11Z","timestamp":1513601591000},"source":"Crossref","is-referenced-by-count":9,"title":["Relation between electrical and mechanical dyssynchrony in patients with left bundle branch block: An electro\u2010 and vectorcardiographic study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3135-8676","authenticated-orcid":false,"given":"Jan","family":"De Pooter","sequence":"first","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"El Haddad","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Kamoen","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Tibin","family":"Kallupurackal","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Stroobandt","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"De Buyzere","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Timmermans","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000118502.91105.F6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-10-1268"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.03.050"},{"key":"e_1_2_9_5_1","first-page":"103","article-title":"The electrocardiographic characteristics of septal flash in patients with left bundle branch block","volume":"19","author":"Corteville B.","year":"2017","journal-title":"Europace"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13132"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.01.129"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.03.045"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2014.10.003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur235"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.110.961417"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.08.715"},{"key":"e_1_2_9_14_1","article-title":"Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: Results from the Markers and Response to CRT (MARC) study","author":"Maass A. 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