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July 9, 2019Journal of ElectrocardiologyOpen Access

Fully automated ECG QRS area matches manual assessment for stratifying CRT response.

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Why the study?

QRS area offers superior association with CRT response compared to standard criteria, but its assessment was not fully automated and required expert evaluation.

Does a fully automated method for assessing QRS area correlate with manual assessment and predict response to CRT in patients with heart failure?

Population

864 pre-implantation ECG recordings (695 left-bundle-branch block, 589 men)

Comparison

Fully automated assessment of VCG QRS area vs manual expert determination

Follow-up

5-year

Key result

A fully automated method for assessing QRS area from ECG signals demonstrated similar prognostic stratification for cardiac resynchronization therapy response as manual assessment (HR 2.09 vs 2.03).

Authors

FPFilip PlešingerASAntonius van StipdonkRSRadovan Smíšek

Discussion

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Member takes

Overview

May support automated QRS area for CRT stratification; leaves open prospective validation before practice change.

Study Design

Type

Cohort (n=864)

Structured PICO

Does a fully automated method for assessing QRS area correlate with manual assessment and predict response to CRT in patients with heart failure?

P
Population
864 patients (695 with left-bundle-branch block, 31.8% female) evaluated for cardiac resynchronization therapy response over a 5-year follow-up.
E
Exposure
Fully automated method for assessment of vector-cardiographic (VCG) QRS area from electrocardiographic (ECG) signals.
C
Comparator
Manually determined QRS area by an expert.
O
Outcome
Correlation between automated and manual QRS area values, and ability to stratify population for CRT response.surrogate

Main Result

Hazard Ratio: 2.09

A fully automated method for assessing QRS area from ECG signals is highly correlated with expert manual assessment and equally effective at predicting CRT response, eliminating the need for manual measurement.

Cite This Study

Plešinger et al. (2019) conducted a cohort in Heart failure and conduction abnormalities (patients undergoing cardiac resynchronization therapy) (n=864). Fully automated assessment of vector-cardiographic QRS area vs. Manually determined QRS area was evaluated on Ability to stratify the population for response to cardiac resynchronization therapy (HR 2.09). A fully automated method for assessing QRS area from ECG signals demonstrated similar prognostic stratification for cardiac resynchronization therapy response as manual assessment (HR 2.09 vs 2.03).

synapsesocial.com/papers/6aa91fd4891b7ede700c01c0https://doi.org/10.1016/j.jelectrocard.2019.07.003
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Vectorcardiographic QRS area as a predictor of response to cardiac resynchronization therapy.2022 · 3 citations
  2. 2QRS area as a predictor of cardiac resynchronization therapy response: A systematic review and meta‐analysis2022 · 10 citations
  3. 3The electrical substrate of vectorcardiographic QRS area in cardiac resynchronization therapy: insights from ECG-imaging2024
  4. 4Baseline QRS Area and Reduction in QRS Area Are Associated with Lower Mortality and Risk of Heart Failure Hospitalization after Cardiac Resynchronization Therapy2022 · 7 citations
  5. 5QRS Complex Detection and Measurement Algorithms for Multichannel ECGs in Cardiac Resynchronization Therapy Patients2018 · 28 citations