QRS Duration and Bundle Branch Block Pattern - Prevalence in Heart Failure with Preserved Ejection Fraction

Left bundle branch block (LBBB) and prolonged QRS duration (QRSd) causes dysynchronous contraction of the left ventricle (LV) and is used to select patients with heart failure (HF) and reduced ejection fraction (HFREF) who may benefit from cardiac re-synchronisation therapy (CRT). Heart failure with preserved ejection fraction (HFPEF) is a distinct clinical syndrome resulting from impaired LV relaxation. Our study investigated the prevalence of LBBB and QRS duration in patients with HFPEF. We utilised a prospectively collected database enrolling all patients seen in a tertiary hospital HF clinic. ECG's were independently assessed. Patients were grouped according to ejection fraction (EF). HFPEF was defined as an EF >40% and further subdivided according to EF. 190 patients with HFPEF were identified. A previously analysed HFREF group was used as a comparator.Table 1.Table 1Prevalence of LBBB and mean QRSd in patients with HF.HFPEFEF 40– 55%EF >55%EF recoveredHFREFNumber19083733486LBBB (%)15.820.56.823.557.0QRSd with LBBB153.6153.4154.8153.8143.9QRSd without BBB94.896.690.5101.197.5QRsd all patients106.7111.499.0112.9115.1 Open table in a new tab Although less frequent than in patients with HFREF, a significant number of HFPEF patients have LBBB and prolonged QRS duration. The role of cardiac resynchronisation in these patients should be explored.