Use of T-wave duration and Tpeak-Tend interval as new prognostic markers for patients treated with cardiac resynchronization therapy

BACKGROUND: The use of electrocardiography (ECG) is a practical method to evaluate the response to cardiac resynchronization therapy (CRT) implantation, as it is easily performed and saves time. AIM: This study aimed to assess the predictive value of the T-wave duration and Tpeak-Tend (Tp-e) interval following the CRT implantation administered to heart failure patients. METHODS: Sixty-seven patients with left ventricular ejection fraction ≤35, New York Heart Association (NYHA) class II-III, ambulatory class IV, normal sinus rhythm, who have complete left bundle branch block on ECG and treated with CRT were included in this study. Patients who have manifested a ≥10% improvement in ejection fraction following CRT implantation, were categorized as "responders", and the remaining patients were categorized as "non-responders". ECGs and echocardiograms were evaluated both six months before and after CRT implantation. RESULTS: The post-CRT QRS duration (P = 0.01), cQT interval (P = 0.005), T-wave (P <0.001), and Tp-e interval (P <0.001) were found to be significantly reduced in the responder group compared to the non-responder group. The receiver operating characteristics curve analyses revealed that the predictive optimal cut-off of the T-wave was <182 ms (P <0.001), and that of the Tp-e interval was <92 ms (P <0.001). CONCLUSIONS: T-wave and Tp-e interval may be independent predictors of a favorable CRT response in heart failure patients.