The effect of QRS duration on cardiac resynchronization therapy in patients with a narrow QRS complex: a subgroup analysis of the EchoCRT trial
Key result
In patients with a QRS duration of 120-130 ms, cardiac resynchronization therapy increased the risk of the primary endpoint compared to CRT-OFF (HR 2.18; 95% CI 1.02-4.65; P=0.044).
Why the study?
Does cardiac resynchronization therapy improve outcomes in patients with echocardiographic left ventricular dyssynchrony and a QRS duration of 120-130 ms?
Study Design
Type
RCT (n=800)
Structured PICO
Does cardiac resynchronization therapy improve outcomes in patients with echocardiographic left ventricular dyssynchrony and a QRS duration of 120-130 ms?
P
Population
800 patients with a QRS duration of <130 ms and echocardiographic evidence of left ventricular dyssynchrony, analyzed in a subgroup of the EchoCRT trial.
I
Intervention
Cardiac resynchronization therapy (CRT-ON)
C
Comparator
Control group (CRT-OFF)
O
Outcome
Primary outcome (not explicitly defined in abstract)
Main Result
Hazard Ratio: 2.18 (95% CI 1.02–4.65)
p-value: p=0.044
CRT provides no benefit and may increase risk in patients with echocardiographic dyssynchrony and a QRS duration of 120-130 ms, questioning its usefulness in this population.
Authors
Discussion
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Implication
CRT should be avoided for QRS 120-130 ms; challenges extension of indications based on echocardiographic dyssynchrony alone.
Cite This Study
Steffel et al. (2015) conducted an RCT in Heart failure (n=800). Cardiac resynchronization therapy (CRT-ON) vs. CRT-OFF was evaluated on Primary endpoint (HR 2.18, 95% CI 1.02-4.65, p=0.044). In patients with a QRS duration of 120-130 ms, cardiac resynchronization therapy increased the risk of the primary endpoint compared to CRT-OFF (HR 2.18; 95% CI 1.02-4.65; P=0.044).