摘要
心脏的再同步治疗(CRT ) 与左捆分支块(磅) 仅仅在病人与有利结果被联系模式并且在有 QRS 持续时间 > 的病人；150 ms，在有有 120-150 的 QRS 持续时间的 non-LBBB 模式的病人， ms 通常不是有益的。在为 QRS 持续时间调整以后， QRS 形态学不再是对 CRT 的临床的反应的一个决定因素。与主流的看法相对照，我们假设了在有 non-LBBB 和 120-150 ms 的 QRS 持续时间的病人的相反的 CRT 结果不由于 QRS 形态学自己，但是到在这亚群的更少的 dyssynchrony 和相反的耐心的特征，例如更多的 ischemic 病原学和男病人的更大的流行与有磅模式的病人相比。进一步，当前的 CRT 技术被设计与磅模式消除在病人在场的 dyssynchrony 并且对不恰当与 non-LBBB 在病人消除 dyssynchrony 模式。我们也假设了那 electrocardiography 可以也关于 interventricular 和左 intraventricular dyssynchrony 和近似地点的存在提供信息最近激活左室(LV ) 区域。到这个目的，我们设计了新 ECG 标准估计 interventricular 和 LV intraventricular dyssynchrony 和最近的激活的 LV 区域的近似地点。我们的初步的数据证明在有骚乱(NICD ) 模式可能在从那的一个遥远的地点的 nonspecific intraventricular 传导的病人的最近的激活的 LV 区域与磅模式在病人介绍，它可能与 NICD 模式为病人要求一种新奇 CRT 技术的发明。新 interventricular 和 LV intraventricular dyssynchrony ECG 标准和一种潜在的新奇 CRT 技术的申请可能减少在有 NICD 的病人的当前高的 nonresponder 率模式。
Cardiac resynchronization therapy （CRT） is associated with a favorable outcome only in patients with left bundle branch block （LBBB） pattern and in patients with a QRS duration 〉 150 ms, in patients with non-LBBB pattern with a QRS duration of 120-150 ms usually is not beneficial. After adjusting for QRS duration, QRS morphology was no longer a determinant of the clinical response to CRT. In contrast to the mainstream view, we hypothesized that the unfavorable CRT outcome in patients with non-LBBB and a QRS duration of 120-150 ms is not due to the QRS morphology itself, but to less dyssynchrony and unfavorable patient characteristics in this subgroup, such as more ischemic etiology and greater prevalence of male patients compared with patients with LBBB pattern. Further, the current CRT technique is devised to eliminate the dyssynchrony present in patients with LBBB pattern and inappropriate to eliminate the dyssynchrony in patients with non-LBBB pattern. We also hypothesized that electrocardiography may also provide information about the presence of interventricular and left intraventricular dyssynchrony and the approximate location of the latest activated left ventricular （LV） region. To this end, we devised new ECG criteria to estimate interventricular and LV intraventricular dyssynchrony and the approximate location of the latest activated LV region. Our preliminary data demonstrated that the latest activated LV region in patients with nonspecific intraventricular conduction disturbance （NICD） pattern might be at a remote site from that present in patients with LBBB pattern, which might necessitate the invention of a novel CRT technique for patients with NICD pattern. The application of the new interventricular and LV intraventricular dyssynchrony ECG criteria and a potential novel CRT technique might decrease the currently high nonresponder rate in patients with NICD pattern.
