Preimplant Left Ventricular End‐Diastolic Dimension and Body Weight Independently Associate With Paced QRS Duration in Patients Receiving Right Ventricular Apical Pacing for Complete Atrioventricular Block

BACKGROUND: Paced QRS duration, a good marker of ventricular asynchrony while pacing, has been accepted as a valuable predictor of new-onset heart failure in patients receiving right ventricular apical pacing. But nowadays we have little evidence for predicting paced QRS duration before the implantation. HYPOTHESIS: There might be relationships between paced QRS duration and demographic characteristics, clinical features such as comorbidities, native QRS duration, or preimplant cardiac size. The purpose of this article was to identify potential predictors of paced QRS duration in patients receiving right ventricular apical pacing for complete atrioventricular block. METHODS: One hundred seventy patients with right ventricular apical pacing for complete atrioventricular block were divided into 2 groups according to whether the paced QRS duration was longer than 170 ms or not. Demographic characteristics, clinical features, electrocardiogram and echocardiography before implantation, and electrocardiogram immediately after implantation, were retrospectively recorded. RESULTS: Preimplant left ventricular end-diastolic dimension (LVEDD) and body weight were found to be independently associated with the paced QRS duration. Although both of them had low sensitivity and specificity in predicting paced QRS duration longer than 170 ms, the specificity could increase to 81.2% when they were combined. CONCLUSIONS: Both preimplant LVEDD and body weight independently associate with paced QRS duration in patients receiving apical pacing for complete atrioventricular block. Although whether they really have an effect on new-onset heart failure still needs to be verified, and these findings might be a good indication.