We present the imaging finding in a 64-year-old patient with heart failure (left ventricular ejection fraction: 20%) and intermittent left bundle branch block (LBBB). Change of QRS morphology from LBBB to right bundle branch block (arrow) causes instantaneous 68% increase in stroke volume, 4% increase in ventricular pulse pressure, and 10% increase in dP/dT, illustrating the negative hemodynamic impact of LBBB in patients with systolic heart failure. The image illustrates in real time the negative hemodynamic impact of LBBB in patients with chronic systolic heart failure [Figure 1].
Figure 1.
Simultaneous stroke volume (a), left ventricular pressure (b), dP/dT (c) and electrocardiogram lead II (d)
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
