{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:49:59Z","timestamp":1747187399251,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Marked QRS widening in patients with left bundle branch block (LBBB) may reduce efficacy of cardiac resynchronization therapy (CRT). We hypothesized that extreme QRS prolongation may accompany right ventricular (RV) dilatation\/systolic dysfunction (RVD\/RVsD) as well as left ventricular dilatation\/systolic dysfunction (LVD\/LVsD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed rates of both ventricular dilatation and systolic dysfunction according to widening of QRS duration (QRSd) in 100 consecutive cardiomyopathy patients with true LBBB (QRSd\u00a0\u2265\u00a0130\u00a0ms in female or \u2265140\u00a0ms in male, QS or rS in leads V1\/V2, and mid\u2010QRS notching\/slurring in \u22652 contiguous leads of I, aVL, and V1\/V2\/V5\/V6). Ventricular dimensions and function were measured by cardiac magnetic resonance imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a trend toward an increase in the prevalence of LVD (13%, 20%, and 90%), LVsD (67%, 77%, and 90%), RVD (23%, 27%, and 50%), RVsD (27%, 27%, and 40%), RVD plus RVsD (13%, 17%, and 40%), or RVD\/RVsD (37%, 37%, and 50%) according to the degree of QRS prolongation (&lt;150\u00a0ms, n\u00a0=\u00a030; 150\u2013180\u00a0ms, n\u00a0=\u00a060; and \u2265180\u00a0ms, n\u00a0=\u00a010). Similarly, patients in the highest quartile of QRSd (QRSd\u00a0\u2265\u00a0168\u00a0ms, n\u00a0=\u00a026) showed greater rates of RVD (23% vs. 44%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.069), RVsD (22% vs. 48%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.032), RVD plus RVsD (10% vs. 30%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.040), or RVD\/RVsD (33% vs. 57%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.050) compared to those in the remaining quartiles (n\u00a0=\u00a074). QRSd\u00a0\u2265\u00a0180\u00a0ms was identified as an independent predictor for the presence of RVD plus RVsD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rates of RVD and\/or RVsD increased with QRS widening, particularly when QRSd exceeded 180\u00a0ms. This may diminish anticipated CRT response rates in cardiomyopathy patients with LBBB.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14357","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T19:14:10Z","timestamp":1631214850000},"page":"1890-1896","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Right ventricular dilatation and systolic dysfunction and relationship to QRS duration in patients with left bundle branch block and cardiomyopathy"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3288-0594","authenticated-orcid":false,"given":"Seung\u2010Jung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic  Cleveland OH USA"},{"name":"Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah H","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1559-0803","authenticated-orcid":false,"given":"John W","family":"Rickard","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2296-2596","authenticated-orcid":false,"given":"Niraj","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Heart and Vascular Institute Cleveland Clinic  Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101685"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.01.022"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut206"},{"key":"e_1_2_6_5_1","first-page":"1463","article-title":"Avoiding non\u2010responders to cardiac resynchronization therapy: a practical guide","volume":"38","author":"Daubert C","year":"2017","journal-title":"Eur Heart 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