Is there a utility for QRS dispersion in clinical practice?

Prognostic markers derived from standard ECG have always been seductive. Increased dispersion of durations of the P wave, of the QRS complex, or of the QT interval has been associated with the risk of atrial fibrillation, ventricular arrhythmias, sudden cardiac death, as well as with a general negative prognosis in various settings. However, these markers have intrinsic and methodological issues that question their utility. This paper presents data supporting the utility of QRS dispersion in clinical practice. Our investigation shows that QRS dispersion is a simple electrocardiographic marker with potential value in the assessment of patients in a variety of clinical settings: ischemic heart disease, heart failure, and cardiomyopathies. More studies are needed to validate QRS clinical utility for predicting the risk for ventricular arrhythmias and sudden cardiac death, and for the evaluation of the response to cardiac resynchronization therapy.