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Left ventricular systolic failure has traditionally been attributed to left ventricular remodeling due to intrinsic abnormalities of myocyte function and subsequent derangements in neurohumoral activation.
Only during the recent decade, abnormalities in left ventricular performance due to abnormal activation patterns have gained more widespread attention in the cardiology literature and in clinical practice.
Such a nonspecific intraventricular conduction defect also presents with a QRS interval prolongation of 0.12 s or more but with a pattern of QRS that does not correspond to the classical pattern of left (or right) bundle branch block.
It should be noted that the term block does not necessarily imply a complete interruption of conduction but may be due to major delay of conduction in some parts of the conduction system which explains the variety of morphologies that can be observed and the frequently nonspecific patterns of conduction delay [Besides the typical prolongation of QRS above 0.11 s, there is a delay of the intrinsic deflection in leads V5 and V6 of more than 60 ms, and there are typically no septal q waves in leads I, V5, and V6 due to the abnormal septal activation from right to left.
This very recent interest has mainly been stimulated by the very successful introduction of cardiac resynchronization therapy (CRT) as a new, device-based treatment option for patients with end-stage heart failure and ventricular conduction delays in the mid-1990s .
However, the initial observations on the negative consequences of abnormal electrical ventricular activation on mechanical cardiac performance date back much earlier and were first described already soon after the introduction of invasive and non-invasive imaging techniques into clinical cardiology .
100 % Czech traditional hand-craft product made of natural materials. corn husk from ripe corn cobs, serve as a material for the manufacture of figures representing countryside activities, household chores. Patients with anterior (paradox) movement during meso- and late systole (group A) had more severe clinical disease than did patients in group B. On X-ray, their cardiothoracic ratio was larger, and on M-mode echocardiography, they had larger LV end-diastolic diameters.Mean values of septal movement of patients with an intermediate pattern during meso- and late systole fell between those with an anterior (paradox) and those with a normal pattern.Among these patients, 10,356 (69%) had LBBB, 1,638 (11%) had right bundle branch block, and 2,952 (20%) had a nonspecific intraventricular conduction disturbance.During a median follow-up of 40 months, patients without LBBB had significantly increased early and late mortality compared to patients with LBBB since a positive response to CRT will mostly be confined to those with LBBB.