Author + information
- Umut Celikyurt,
- Kurtulus Karauzum,
- Neslihan Al,
- Tayfun Sahin,
- Aysen Agacdiken,
- Ahmet Vural and
- Dilek Ural
Cardiac resynchronization therapy (CRT) is an established treatment for patients with symptomatic heart failure and a wide QRS complex. Fragmented QRS (fQRS) on a 12-lead electrocardiography (ECG) has been shown to predict cardiac events. We aimed to investigate the relationship between resolution of fQRS and response to CRT.
Sixty-seven consecutive patients (38 men, mean age 65±11) with fQRS undergoing CRT were studied. The presence of fQRS was assessed using standardized criteria. The resolution of fQRS was assessed on post-implantation ECG. Echocardiographic response to CRT was defined by a ≥15% reduction in left ventricular end-systolic volume (LVESV) at 6 months follow-up.
The baseline clinical and echocardiographic variables of responder and non-responder patients showed no statistically significant difference. Thirty-nine patients (58%) had response to CRT. Left ventricular end-systolic volume significantly decreased from 150±64 to 100±48 in responder patients (p=0.001). There was not any significant decrease in LVESV in non-responder patients (157±70 vs. 153±66, p=0.45). Number of leads with fQRS decreased from 4.4±1.8 to 1.7±1.6 in responder patients (p<0.001). Number of leads with fQRS was not significantly changed in non-responder patients (4.2±2.2 vs. 5.1±2.4, p=0.06). In multivariate analysis, significant associates of response to CRT was evaluated adjusting for etiology of cardiomyopathy, baseline QRS width, baseline left ventricular ejection fraction, number of leads with fQRS and resolution of fQRS. Resolution of fQRS was the only predictor of response to CRT (OR 0.018, 95% CI, 0.004-0.083, p<0.001).
Resolution of fQRS on post-implantation ECG could predict response to CRT.