Why the study?
Previous studies suggest a positive correlation between QRS area and response to CRT, but its clinical use remains unclear.
Does a larger pre-implantation QRS area predict improved survival in patients undergoing cardiac resynchronization therapy?
Population
4931 patients across 5 observational studies
Comparison
Large vs small QRS area before CRT, and greater vs lesser QRS area reduction
Design
Systematic review and random-effects meta-analysis
Key result
A larger pre-implantation QRS area was associated with increased 5-year survival in patients implanted with cardiac resynchronization therapy (HR 0.48; 95% CI 0.46-0.51; p < 0.0001).
Authors
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Supports QRS area for CRT risk stratification; confirms its prognostic value beyond QRS duration.
Meta-Analysis (n=4,931)
Does a larger pre-implantation QRS area predict improved survival in patients undergoing cardiac resynchronization therapy?
Effect estimate: HR 0.48 (95% CI 0.46-0.51)
p-value: p=< .0001
A larger pre-implantation QRS area and greater QRS area reduction are strong predictors of improved survival following cardiac resynchronization therapy.
Tokavanich et al. (2022) conducted a meta-analysis in Patients requiring cardiac resynchronization therapy (CRT) (n=4,931). Larger QRS area vs. Smaller QRS area was evaluated on 5-year survival (HR 0.48, 95% CI 0.46-0.51, p=< .0001). A larger pre-implantation QRS area was associated with increased 5-year survival in patients implanted with cardiac resynchronization therapy (HR 0.48; 95% CI 0.46-0.51; p < 0.0001).