Why the study?
Does diuretic therapy increase paced QRS complex amplitudes in correlation with body weight loss in pacing-dependent patients with heart failure?
Cohort (n=32)
Measurements of the amplitude of the paced QRS complexes in ECG leads were made by a single doctor blinded to the study
Does diuretic therapy increase paced QRS complex amplitudes in correlation with body weight loss in pacing-dependent patients with heart failure?
Changes in the amplitude of paced QRS complexes correlate strongly with fluid and weight loss during diuresis and may serve as a simple bedside tool to monitor decongestive therapy in pacing-dependent heart failure patients.
Answers are grounded in this paper and cite their sources.
May support paced QRS amplitude as a decongestive marker in HF; hypothesis-generating pending prospective validation.
BACKGROUND: Augmentation of the amplitude of QRS complexes with diuretic therapy for patients with congestive heart failure has been well documented. However, the effect of diuresis on the paced QRS complexes in pacing-dependent patients with heart failure is scarce. OBJECTIVE: To investigate the effect of diuresis on the paced QRS complexes in pacing-dependent patients with heart failure. METHOD: Thrity-two consecutive pacing-dependent patients with heart failure were enrolled in this study. Before and after diuresis, the sums of paced QRS amplitude of leads I+II (ΣpQRSI+II ), six limb leads (ΣpQRS6L ), leads V1 -V3 (ΣpQRSV1-V3 ), leads V4 -V6 (ΣpQRSV4-V6 ), leads V1 -V6 (ΣpQRSV1-V6 ), and lead aVR (pQRSaVR ), paced QRS duration (pQRSd ), paced QT intervals (pQT) and the body weight of each patient were measured, then the % changes (Δ%) in paced electrocardiogram (ECG) variables and the Δ% in body weight were evaluated. RESULTS: Compared with before diuresis, paced ECG variables significantly increased and body weight significantly decreased after diuresis, Δ% in paced QRS amplitude(s) in all ECG variables (ΣpQRSI+II, ΣpQRS6L, ΣpQRSV1-V3 , ΣpQRSV4-V6 , ΣpQRSV1-V6 , and pQRSaVR ) correlated well with Δ% in body weight (r = 0.416, r = 0.849, r = 0.901, r = 0.371, r = 0.837, r = 0.619, and P = 0.018, P < 0.001, P < 0.001, P = 0.037, P < 0.001, P < 0.001), while there was no correlation between Δ% in pQRSd and pQT and Δ% in body weight. CONCLUSIONS: The changes in amplitude of paced QRS complexes may be useful for the monitoring of therapy of pacing-dependent patients with heart failure.
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Sheng et al. (2015) conducted a cohort in Pacing-dependent heart failure (n=32). Furosemide diuretic therapy vs. Baseline (before diuresis) was evaluated on Correlation between percentage change (Δ%) in paced QRS amplitudes (such as ΣpQRSV1-V3) and percentage change (Δ%) in body weight before and after 7 days of diuresis (r = 0.901 for Δ% in ΣpQRSV1-V3 vs Δ% in body weight, p=<0.001).
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