Prevalence of manual Strauss LBBB criteria in patients diagnosed with the automated Glasgow LBBB criteria

• We compared the Strauss LBBB criteria to the established Glasgow LBBB criteria.
• Most patients diagnosed by the Glasgow criteria were positive for Strauss criteria.
• Discrepancies were mainly due to differences in QRS duration thresholds.
• There may be a need for different LBBB criteria in different clinical situations.

IntroductionAbout one-third of patients undergoing cardiac resynchronization therapy because of left bundle branch block (LBBB) and heart failure do not improve. Strauss et al. have developed strict criteria to more accurately define complete LBBB in this patient group. The aim of this study was to investigate the prevalence of the manual application of the Strauss criteria for LBBB (QRS ≥ 140 ms in men, ≥ 130 ms in women, along with mid-QRS notching/slurring) in consecutive patients who have been diagnosed with LBBB by the automated Glasgow criteria (QRS ≥ 120 ms).MethodIn 158 consecutive patients (78 females) diagnosed with LBBB according to the automated Glasgow criteria, the manual Strauss criteria were applied.Results & conclusionA majority of patients (87%) diagnosed with LBBB using the Glasgow criteria were positive for the Strauss criteria. In 70% (13/20) of the cases of disagreement the reason for disagreement was short QRS duration.