Key result
A QRS area reduction ≥62 µVs after cardiac resynchronization therapy was associated with a lower risk of mortality, heart transplantation, or LVAD implantation (HR 0.43; 95% CI 0.33-0.56; p<0.001).
Why the study?
While baseline QRS area is known to associate with clinical response after CRT, the association between QRS area reduction after CRT and clinical outcomes remained to be determined.
Does a larger QRS area reduction (≥62 µVs) after cardiac resynchronization therapy improve survival and echocardiographic response in patients receiving CRT?
Population
1299 patients in a multi-center CRT-registry
Comparison
QRS area reduction above vs below optimal cut-off value (62 µVs)
Design
Multi-center registry study
Authors
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∆QRS area reduction ≥62 µVs was associated with lower composite risk after CRT; hypothesis-generating and requires prospective validation before clinical use.
Cohort (n=1,299)
Yes
Does a larger QRS area reduction (≥62 µVs) after cardiac resynchronization therapy improve survival and echocardiographic response in patients receiving CRT?
Hazard Ratio: 0.43 (95% CI 0.33–0.56)
p-value: p=< .001
A reduction in QRS area ≥62 µVs after CRT is an independent predictor of improved survival and echocardiographic response, particularly in patients with a large baseline QRS area.
Ghossein et al. (2021) conducted a cohort in Heart failure requiring cardiac resynchronization therapy (n=1,299). QRS area reduction (∆QRS area) ≥62 µVs after CRT vs. ∆QRS area <62 µVs was evaluated on Combination of all-cause mortality, heart transplantation, and left ventricular (LV) assist device implantation (HR 0.43, 95% CI 0.33-0.56, p=< .001). A QRS area reduction ≥62 µVs after cardiac resynchronization therapy was associated with a lower risk of mortality, heart transplantation, or LVAD implantation (HR 0.43; 95% CI 0.33-0.56; p<0.001).