Physiologic Insights and Clinical Consequences of Mechanical Discoordination in Left Bundle Brranch Block

Abstract

Conduction disturbances are present in a large number of heart failure patients. In particular left bundle branch block has subsequent deleterious effects on cardiac structure, function, and efficiency. Cardiac resynchronization therapy is a device based therapy that aims to improve cardiac mechanics by restoring electrical activation. The response in individual patients is highly variable and one of the reasons is the variability in amenable mechanical substrate. How to define, assess and quantify this mechanical substrate however remains unclear. The thesis aims to extend the physiologic insights into the mechanical consequences of left bundle branch block in heart failure patients to improve the diagnostic approaches and to optimize therapy delivery in clinical practice.