Usefulness of prolonged QRS duration to identify high-risk ischemic cardiomyopathy patients with syncope and inducible ventricular tachycardia.
We evaluated 61 consecutive patients who had coronary artery disease, decreased left ventricular function, and syncope and underwent implantation of a cardioverter-defibrillator because sustained ventricular tachycardia was inducible at electrophysiologic testing. During a follow-up of 3.0 +/- 1.8 years, 23 patients (38%) developed ventricular tachycardia. Prolonged QRS duration (>/=120 ms) was the only significant predictor of arrhythmia. The 1- and 2-year rates without ventricular arrhythmia were 82% and 77%, respectively, in patients whose QRS duration was <120 ms. In contrast, 1- and 2-year rates without ventricular arrhythmia were only 64% and 51%, respectively, in patients whose QRS duration was >/=120 ms (risk ratio 3.7, 95% confidence interval 1.4 to 9.8, p = 0.0092).
Guttigoli
Amit B
AB
Department of Medicine, Division of Cardiology, Cornell University Medical Center, New York, New York, USA.
Wilner
Brian F
BF
Stein
Kenneth M
KM
Markowitz
Steven M
SM
Iwai
Sei
S
Shah
Bindi K
BK
Yarlagadda
Ravi K
RK
Lerman
Bruce B
BB
Mittal
Suneet
S
D000368:Aged; D016009:Chi-Square Distribution; D017147:Defibrillators, Implantable; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D013575:Syncope / Q000150:complications / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*