Left bundle branch block: Epidemiology, etiology, anatomic features, electrovectorcardiography, and classification proposal.
Andrés Ricardo Pérez RieraRaimundo Barbosa-BarrosMarianne Penachini da Costa de Rezende BarbosaRodrigo Daminello-RaimundoLuiz C de AbreuKjell NikusPublished in: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc (2018)
In left bundle branch block (LBBB), the ventricles are activated in a sequential manner with alterations in left ventricular mechanics, perfusion, and workload resulting in cardiac remodeling. Underlying molecular, cellular, and interstitial changes manifest clinically as changes in size, mass, geometry, and function of the heart. Cardiac remodeling is associated with progressive ventricular dysfunction, arrhythmias, and impaired prognosis. Clinical and diagnostic notions about LBBB have evolved from a simple electrocardiographic alteration to a critically important finding affecting diagnostic and clinical management of many patients. Advances in cardiac magnetic resonance imaging have significantly improved the assessment of patients with LBBB and provided additional insights into pathophysiological mechanisms of left ventricular remodeling. In this review, we will discuss the epidemiology, etiologies, and electrovectorcardiographic features of LBBB and propose a classification of the conduction disturbance.
Keyphrases
- left ventricular
- heart failure
- hypertrophic cardiomyopathy
- magnetic resonance imaging
- cardiac resynchronization therapy
- acute myocardial infarction
- aortic stenosis
- left atrial
- mitral valve
- end stage renal disease
- machine learning
- deep learning
- ejection fraction
- risk factors
- newly diagnosed
- prognostic factors
- multiple sclerosis
- chronic kidney disease
- peritoneal dialysis
- oxidative stress
- atrial fibrillation
- coronary artery disease
- patient reported outcomes
- transcatheter aortic valve replacement