الفهرس 
Cardiac Resynchronization TherapyOnly 14 pages are availabe for public view
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Abstract
Cardiac resynchronization therapy (CRT) is one of the most important therapeutic advancements in recent years for patients with heart failure with reduced ejection fraction (HFrEF). Throughout the past two decades, numerous trials and studies have repeatedly illustrated the efficacy of CRT to improve outcomes in carefully selected patients by eliminating the dysynchrony which results from bundle branch block activation and restore the mechano-energetic efficiency of the heart.
During CRT, both the left and right ventricles are stimulated in an attempt to re-coordinate cardiac electrical activation and produce a synchronous and efficient contraction. However, 20% to 40% of patients are non-responders to CRT therapy. Several variables, including cause of HF, pattern of mechanical dysynchrony, ECG morphology and site of LV pacing, have been investigated as predictors of response.
Our study included 70 patients underwent CRT or CRT-D implantation with LBBB morphology following ESC guidelines of diagnosis and management of acute and chronic HF 2016 about CRT implantation (Symptomatic patients with HF in sinus rhythm with LVEF ≤35, QRS duration≥ 130 msec and LBBB morphology despite OMT) in Ain Shams university hospitals, Cardiology department, from March 2020 to March 2022.
All patient that underwent CRT or CRT-D implantation with LBBB morphology (Strauss and non-Strauss ECG criteria) in ECG were included in our study.
Patients with heart failure symptoms but not fulfilling any criteria of CRT implantation, Patient underwent implantation of Cardiac resynchronization therapy with non-LBBB morphology, Patient not achieving Biv Pacing 99% in 6 month follow up programming, Patients had periprocedural complications during CRT implantation, Patients with persistent AF and Patient with previously Right ventricle pacing all were excluded from our study.
Our patients divided into two group according to ECG morphology of LBBB (Strauss and non-Strauss group) who underwent CRT implantation, baseline ECG, Echocardiography and STE was done before CRT implantation and after 6 months to assess CRT response.