LBBB in the After Mode
LBBB in the After Mode

Summary/Abstract: The left bundle branch block (LBBB) causes an abnormal pattern of cardiac activation and affects the regional myocardial function. Although the recognition of LBBB on the surface electrocardiogram is straightforward, dissecting its effect on patient treatment and outcome can be rather more challenging. The altered pattern of cardiac activation in LBBB causes electrical and mechanical ventricular dyssynchrony, influences ischemia detection on the surface electrocardiogram, and affects stress testing and imaging modalities dependent on wall motion and thickening. Indeed, the presence of LBBB on a 12-lead electrocardiogram, whether new or established, poses multiple important and perplexing questions to healthcare providers and should be considered a “cardiac clinical entity,” rather than just an electrocardiographic finding. Its presence has far-reaching consequences in acute clinical care, such as in the setting of acute myocardial infarction (AMI), and in chronic conditions, such as heart failure (HF), where it can be helpful in guiding cardiac resynchronization therapy (CRT).

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