Cardiac resynchronization therapy in heart failure patients with narrow QRS (≤120 ms) resulted in a lower long-term death rate from HF compared to those with wide QRS (P=0.04).
Cohort (n=376)
Does cardiac resynchronization therapy (CRT) improve clinical outcomes and survival in heart failure patients with narrow QRS compared to those with wide QRS?
CRT provides significant long-term clinical, functional, and survival benefits in heart failure patients with narrow QRS, suggesting QRS width alone should not preclude CRT.
p-value: p=0.04
AIM OF THE STUDY: To examine the long-term effects of cardiac resynchronization therapy (CRT) in patients presenting with heart failure (HF) and QRS 120 ms in the remaining 331 patients. The baseline characteristics of the 2 groups were similar. We evaluated indices of cardiac function, percentage of responders, and survival rates over a mean 28-month follow-up. RESULTS: Both groups experienced similar long-term increases in 6-MHW, and decreases in New York Heart Association functional class and LV end-systolic volume (all comparisons P < 0.0001 in both groups). Time interaction of changes in LVEF and percentage of responders were significantly different (P = 0.03 and P = 0.004, respectively), in favor of the narrow QRS group, where the changes were sustained and persisted at 2 and 3 years. The long-term death rate from HF was lower in the group with narrow than in the group with wide QRS complex (P = 0.04; log-rank test). CONCLUSIONS: CRT confers considerable long-term clinical, functional, and survival benefits in patients presenting with HF and narrow QRS, not preselected by echocardiographic criteria of dyssynchrony. Caution is advised before denying CRT to these patients on the basis of QRS width only.
Gasparini et al. (Mon,) conducted a cohort in Heart failure (n=376). Cardiac resynchronization therapy (narrow QRS ≤120 ms) vs. Cardiac resynchronization therapy (wide QRS >120 ms) was evaluated on Long-term death rate from heart failure (p=0.04). Cardiac resynchronization therapy in heart failure patients with narrow QRS (≤120 ms) resulted in a lower long-term death rate from HF compared to those with wide QRS (P=0.04).