Role of QRS Duration and Morphology in Predicting Response to Cardiac Resynchronization Treatment

Cardiac resynchronization therapy (CRT) has become a standard treatment for patients with congestive heart failure (CHF) who remain symptomatic despite maximum medical therapy.Prognostic Role of QRS in Medical Population. QRS duration predicted mortality in approximately 47000 patients that comprised a general medical population.Magnitude of QRS Shortening and CRT Response.More recently use of multi-parameter approach in both wide62 and narrow63 QRS patients has been used with a significant improvement in sensitivity and specificity.More prospective, randomized studies need to be conducted to evaluate role of CRT in narrow QRS patients using multi asynchrony parameter approach. In the meantime responder rate amongst those currently eligible for CRT needs to be improved by focusing on role of viability, coronary sinus venous anatomy, site of electromechanical delay, and pacemaker optimization.