Effect of Cardiac Resynchronization Therapy on Left Ventricular Function in Patients with Heart Failure and Left Bundle Branch Block

Authors

  • Zahoor Ahmad Khan KGMC/MTI-Hayatabad Medical Complex, Peshawar, Pakistan
  • Hameedullah KGMC/MTI-Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.52206/jsmc.2025.15.2.1171

Abstract

Background: Heart failure with Left Bundle Branch Block exacerbates ventricular dyssynchrony, significantly impairing cardiac function. Cardiac Resynchronization Therapy has emerged as a transformative intervention, improving mechanical synchronization and left ventricular function in these patients.
Objective: To evaluated the impact of Cardiac Resynchronization Therapy on left ventricular function in patients with heart failure and Left Bundle Branch Block at Hayatabad Medical Complex, Peshawar.
Material and Methods: A retrospective study was conducted from January 2021 to December 2021, involving 100 patients with heart failure and Left Bundle Branch Block. Patients' data were analyzed for improvements in Left Ventricle Ejection Fraction, New York Heart Association class, and QRS duration. Statistical analyses were performed, with significance set at p < 0.05.
Results: The study revealed significant improvements post-cardiac resynchronization therapy. The mean LVEF improvement was 25.47% (SD ± 9.08), ranging from 10% to 40% (p < 0.05). New York Heart Association class improved by an average of 2.51 points (SD ± 1.16), with most patients achieving a 3–4-point enhancement (p < 0.05). The mean reduction in QRS duration was 54.84 ms (SD ± 25.49), ranging from 10 to 99ms (p < 0.05). Responders, defined as patients with LVEF improvement ≥25%, showed significantly greater QRS reduction (65ms vs. 35ms) and NYHA class improvement (3.1 vs. 1.9 points) compared to non-responders.
Conclusion: Cardiac Resynchronization Therapy significantly improves cardiac function, electrical synchronization, and symptomatic status in heart failure patients with Left Bundle Branch Block. These findings highlight cardiac resynchronization therapy's transformative potential and the importance of precise patient selection. Future research should include multicenter trials and long-term follow-ups to optimize outcomes.
Keywords: Cardiac resynchronization therapy, Heart failure, Left bundle branch block, Left ventricular function, QRS duration.

Author Biography

Zahoor Ahmad Khan, KGMC/MTI-Hayatabad Medical Complex, Peshawar, Pakistan

MBBS, FCPS (Cardiology), FCPS (Cardiac Electrophysiology)

Assistant Professor

References

Shim Y, Kang CM. A case of laparoscopic excision of choledochal cyst, hepaticojejunostomy, and Roux-en-Y anastomosis using Artisential. Ann Hepatobiliary Pancreat Surg. 2024;28(2):266-9. https://doi.org/10.14701/ahbps.23-114

Todani T, Watanabe Y, Narusue M, Tabuchi K, Okajima K. Congenital bile duct cysts: classification, operative procedures, and review of thirty-seven cases including cancer arising from choledochal cyst. Am J Surg. 1977;134:263-9. https://doi.org/10.1016/0002-9610(77)90359-2

Sun R, Zhao N, Zhao K, Su Z, Zhang Y, Diao M, et al. Comparison of efficacy and safety of laparoscopic excision and open operation in children with choledochal cysts: A systematic review and update meta-analysis. PLoS One. 2020;15:e0239857. https://doi.org/10.1371/journal.pone.0239857

Yoon JH, Hwang HK, Lee WJ, Kang CM. Minimally invasive surgery for choledochal cysts: laparoscopic versus robotic approaches. Ann Hepatobiliary Pancreat Surg. 2021;25:71-7. https://doi.org/10.14701/ahbps.2021.25.1.71

Ojha S, Bharadia L, Sharma R, Bansal RK, Chaturvedi A. Laparoscopic choledochal cyst excision and biliary reconstruction in patients with previous surgery/intervention: Feasibility and outcome. J Minim Access Surg. 2024 Apr 1;20(2):121-6. https://doi.org/10.4103/jmas.jmas_269_22

Zheng J, Li Z, Ye Y, Wang B. Short-term complications after laparoscopic choledochal cyst radical surgery: Prevention and treatment. Front Surg. 2020;7:583210. https://doi.org/10.3389/fsurg.2020.583210

Mansy W, El Ekiaby O, Mohamed M. Total cyst excision with Roux-en-Y hepaticojejunostomy for choledochal cyst management: a single-center experience. Egypt J Surg. 2020;39(3):780-6. https://doi.org/10.4103/ejs.ejs_80_20

Yeung F, Fung ACH, Chung PHY, Wong KKY. Short-term and long-term outcomes after Roux-en-Y hepaticojejunostomy versus hepaticoduodenostomy following laparoscopic excision of choledochal cyst in children. Surg Endosc. 2020;34(5):2172-7. https://doi.org/10.1007/s00464-019-07004-5

Diao M, Li L, Cheng W. Laparoscopic management for aberrant hepatic duct in children with choledochal cysts. Surg Endosc. 2019;33:2376-80. https://doi.org/10.1007/s00464-019-06807-w

Reyes N, Sotomayor C, Inzunza M, Briceño E, Viñuela E, Martínez J, et al. Type I choledochal cyst. Total laparoscopic resection and Roux-en-Y reconstruction to two separated ducts. J Surg Case Rep. 2024;8(1):15-9. https://doi.org/10.1093/jscr/rjae543

Brown ZJ, Baghdadi A, Kamel I. Diagnosis and management of choledochal cysts. HPB (Oxford). 2023;25:14-25. https://doi.org/10.1016/j.hpb.2022.09.010

Pakkala AK, Nekarakanti PK, Nagari B. An audit of complicated choledochal cysts: 15-years' experience at a tertiary care center. Langenbecks Arch Surg. 2023;408:212. https://doi.org/10.1007/s00423-023-02952-y

Zhang B, Wu D, Fang Y, Bai J, Huang W, Liu M, et al. Early complications after laparoscopic resection of choledochal cyst. Pediatr Surg Int. 2019;35:845-52. https://doi.org/10.1007/s00383-019-04489-y

Aly MYF, Mori Y, Miyasaka Y. Laparoscopic surgery for congenital biliary dilatation: A single-institution experience. Surg Today. 2018;48:44-50. https://doi.org/10.1007/s00595-017-1545-3

Han JH, Lee JH, Hwang DW. Robot resection of a choledochal cyst with Roux-en-Y hepaticojejunostomy in adults: Initial experiences with 22 cases and a comparison with laparoscopic approaches. Ann Hepatobiliary Pancreat Surg. 2018;22:359-66. https://doi.org/10.14701/ahbps.2018.22.4.359

Friedmacher F, Ford KE, Davenport M. Choledochal malformations: Global research, scientific advances, and key controversies. Pediatr Surg Int. 2019;35:273-82. https://doi.org/10.1007/s00383-018-4392-4

Friedmacher F, Pakarinen MP, Rintala RJ. Congenital diaphragmatic hernia: A scientometric analysis of the global research activity and collaborative networks. Pediatr Surg Int. 2018;34:907-17. https://doi.org/10.1007/s00383-018-4304-7

Pilkington M, Grant CN, Geiger JD, Speck KE. Laparoscopic choledochal cyst resection with hepaticoduodenostomy using a novel articulating instrument in a 19-month-old. Videoscopy. 2019;29(6): https://doi.org/10.1089/vor.2019.0600

Additional Files

Published

10-05-2025

How to Cite

1.
Khan ZA, Hameedullah. Effect of Cardiac Resynchronization Therapy on Left Ventricular Function in Patients with Heart Failure and Left Bundle Branch Block. J Saidu Med Coll [Internet]. 2025 May 10 [cited 2025 Jun. 12];15(2):157-61. Available from: https://jsmc.pk/index.php/jsmc/article/view/1171