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Tuesday, January 31, 2023

Are the Strauss criteria for diagnosis of LBBB best to predict outcome of CRT

 Are the Strauss criteria for LBBB diagnosis best suited to predict favorable outcome for CRT ?

Jastrzebsi et al have published data suggesting that the answer to that question is yes. The authors compared four EKG criteria for the diagnosis for LBBB and then compared the outcomes of CRT of patients defined as having LBBB by the various criteria. Patients with Strauss defined LBBB did better than the patients with LBBB defined by other criteria.

This study supports the notion that LBBB defined by Strauss detects so called "true LBBB" with delayed activation of the lateral left ventricular wall and the abnormal inter-ventricular septum motion which can be detected by the "septal flash" on cardiac echo exam. In other words the Strauss EG patterns seems to detect patients whose conduction defect(s) is most likely to be corrected by CRT differentiating it from various  "non-specific intraventricular conduction defects".


Jastrzebski,M et al Comparison of fojr LBBB definitions for predicting morality in patients receiving cardiac resynchronization therapy. Ann Noninvasive Electro 2018 23 (c) e 12563

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