Key result
A decrease in QRS area of ≥62μVs after CRT was associated with a lower risk of mortality, heart transplantation, or LVAD implantation compared to <62μVs (HR 0.43; 95% CI 0.33-0.56; p<0.001).
Why the study?
To investigate whether the change in QRS area by CRT-pacing further improves the prediction of CRT outcomes beyond baseline QRS area.
Does a larger decrease in QRS area (ΔQRS area ≥62μVs) following cardiac resynchronization therapy improve clinical outcomes in patients with dyssynchronous heart failure?
Population
1,299 patients in a CRT registry from three Dutch University hospitals with pre- and post-implantation ECGs
Comparison
ΔQRS area ≥62μVs vs <62μVs
Design
Retrospective multicentre registry analysis
Authors
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May inform post-CRT prognosis; leaves open whether QRS area reduction is a modifiable target.
Cohort (n=1,299)
Yes
Does a larger decrease in QRS area (ΔQRS area ≥62μVs) following cardiac resynchronization therapy improve clinical outcomes in patients with dyssynchronous heart failure?
Hazard Ratio: 0.43 (95% CI 0.33–0.56)
p-value: p=<0.001
A greater reduction in QRS area following CRT implantation is strongly associated with improved clinical and echocardiographic outcomes, suggesting it could serve as a target for CRT optimization.
Ghossein et al. (2020) conducted a cohort in Dyssynchronous heart failure (n=1,299). Change in QRS area (ΔQRS area) ≥62μVs vs. ΔQRS area <62μVs was evaluated on Combination of all-cause mortality, heart transplantation, and left ventricular assist device implantation (HR 0.43, 95% CI 0.33-0.56, p=<0.001). A decrease in QRS area of ≥62μVs after CRT was associated with a lower risk of mortality, heart transplantation, or LVAD implantation compared to <62μVs (HR 0.43; 95% CI 0.33-0.56; p<0.001).
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