Electrocardiogram and clinical characteristics of patients referred for cardiac transplantation: Implications for pacing in heart failure

BACKGROUND: Permanent pacing for the treatment of heart failure (HF) has been the subject of intense research over the past decade. Those with conduction abnormalities may benefit most from pacing. The incidence of these conduction abnormalities in patients referred for cardiac transplantation and its relationship to outcome has not been well described. HYPOTHESIS: This study sought to determine the incidence of these abnormalities and to correlate these findings to outcome in this patient population. METHODS: A review of 100 patients referred for transplantation was performed. Data were analyzed in two groups: those with QRS duration < 120 ms and those with a QRS duration > 120 ms. Times to transplantation or death were analyzed in these two groups. RESULTS: Of these patients, 34% had QRS duration > or = 120 ms and survival was inversely associated with QRS duration. Of those with QRS duration < 120 ms, 24% (16) went on to cardiac transplantation or died. Of those with a QRS duration > or = 120 ms, 55% (17) went on to transplantation or died (p = 0.0134). CONCLUSIONS: This suggests that in addition to a multi-drug regimen for heart failure, 34% of patients referred for transplantation may benefit from additional therapy with biventricular pacing.