10) A previous study showed that patients with LBBB with LAD had greater incidence of cardiomegaly, HF, advanced conduction disease, cardiovascular mortality, and major adverse cardiac event than those with a normal axis. 7), 8), 9) The proposed mechanisms of LAD in patients with LBBB include attitudinal changes in the anatomy such as a cardiomegaly and changes in myocyte mass.
6) The most common cause of LAD is left anterior fascicular block (LAFB), but LAFB cannot explain the LAD in patients with complete LBBB. 1), 2), 3), 4), 5) Among the randomized population included in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT) trial, LBBB patients without left axis deviation (LAD) appeared to receive a greater benefit from CRT than did those with LAD. Left bundle branch block (LBBB) is a marker of poor prognosis in heart failure (HF) patients, and interest in LBBB is increasing due to the development of cardiac-resynchronization therapy (CRT).
12Division of Cardiovascular and Rare Diseases, Department of Biomedical Science, National Institute of Health (NIH), Osong, Korea. 11Division of Cardiology, Department of Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. 10Division of Cardiology, Department of Medicine, Heart Research Center of Chonnam National University, Gwangju, Korea. 9Division of Cardiology, Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. 8Division of Cardiology, Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 7Division of Cardiology, Department of Medicine, Yonsei University College of Medicine, Seoul, Korea. 6Division of Cardiology, Department of Medicine, The Catholic University of Korea, Seoul, Korea. 5Division of Cardiology, Department of Medicine, Kyungpook National University College of Medicine, Daegu, Korea. 4Division of Cardiology, Department of Medicine, University of Ulsan College of Medicine, Seoul, Korea. 3Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. 2Division of Cardiology, Department of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. 
1Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
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