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QRS Area Is a Strong Determinant of Outcome in Cardiac Resynchronization Therapy
- Source :
- Circulation. Arrhythmia and Electrophysiology, 11(12). Lippincott Williams and Wilkins, Circulation. Arrhythmia and Electrophysiology, 11(12):006497. LIPPINCOTT WILLIAMS & WILKINS, Circulation : Arrhythmia and Electrophysiology, 11, 12, Circulation-Arrhythmia and Electrophysiology, 11(12):006497. LIPPINCOTT WILLIAMS & WILKINS, Circulation : Arrhythmia and Electrophysiology, 11
- Publication Year :
- 2018
-
Abstract
- Background: The combination of left bundle branch block (LBBB) morphology and QRS duration is currently used to select patients for cardiac resynchronization therapy (CRT). These parameters, however, have limitations. This study evaluates the value of QRS area compared with that of QRS duration and morphology in the association with clinical and echocardiographic outcomes in a large cohort of CRT patients. Methods: A retrospective multicentre study was conducted in 1492 CRT patients. LBBB morphology, QRS duration, and QRS area in the baseline 12-lead ECG were evaluated for their association with the occurrence of the combined primary end point of all-cause mortality, cardiac transplantation, and left ventricular assist device implantation. Secondary end points were heart failure hospitalization within the first year after implantation and echocardiographic reduction in left ventricular end-systolic volume. Results: During a mean follow-up period of 3.4 years, 32% of patients reached the primary end point. The association of QRS area with all outcomes was stronger than that of LBBB morphology and QRS duration separately and at least as strong as their combination. QRS area identified patients who did not experience the primary end point better than QRS morphology and QRS duration (area under the curve, 0.61 versus 0.55 and 0.51, respectively; P P Conclusions: QRS area has a strong association to clinical and echocardiographic response to CRT, at least as strong as current patient selection parameters. QRS area may be particularly useful to predict CRT response in patients without a wide LBBB.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
DURATION
Cardiac resynchronization therapy
SOCIETY
cardiac resynchronization therapy
heart failure
030204 cardiovascular system & hematology
COLLABORATION
GUIDELINES
03 medical and health sciences
QRS complex
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Physiology (medical)
Internal medicine
PREDICTS RESPONSE
medicine
Journal Article
030212 general & internal medicine
cardiovascular diseases
VECTORCARDIOGRAM
Bundle branch block
business.industry
Left bundle branch block
Task force
MORTALITY
Stroke volume
ASSOCIATION
bundle-branch block
medicine.disease
Heart failure
stroke volume
Cardiology
cardiovascular system
MORPHOLOGY
Cardiology and Cardiovascular Medicine
business
patient selection
TASK-FORCE
circulatory and respiratory physiology
Subjects
Details
- Language :
- English
- ISSN :
- 19413149
- Database :
- OpenAIRE
- Journal :
- Circulation. Arrhythmia and Electrophysiology, 11(12). Lippincott Williams and Wilkins, Circulation. Arrhythmia and Electrophysiology, 11(12):006497. LIPPINCOTT WILLIAMS & WILKINS, Circulation : Arrhythmia and Electrophysiology, 11, 12, Circulation-Arrhythmia and Electrophysiology, 11(12):006497. LIPPINCOTT WILLIAMS & WILKINS, Circulation : Arrhythmia and Electrophysiology, 11
- Accession number :
- edsair.doi.dedup.....0d737bc4065c9d0b1101b73fcbadb0a5