Number of leads with fragmented QRS predicts response to cardiac resynchronization therapy.
BACKGROUND
Cardiac resynchronization therapy (CRT) is an effective option in the treatment of patients with heart failure (HF) and wide QRS. Fragmented QRS (fQRS) on 12-lead electrocardiography has been shown to predict cardiac events in several patient populations. However, the relationship between the number of leads with fQRS and response to CRT has not been investigated.


OBJECTIVE
The number of leads with fQRS may predict response to CRT.


METHODS
One hundred five patients with HF undergoing CRT were prospectively studied. The presence of fQRS was assessed using standardized criteria. Echocardiographic response to CRT was defined by a ≥15% reduction in left ventricular end-systolic volume at 6 months follow-up.


RESULTS
Seventy-four patients (71%) had CRT response after 6 months of follow-up. In multivariate analysis, significant associates of response to CRT were evaluated adjusting for gender, etiology of cardiomyopathy, QRS width, baseline left ventricular ejection fraction, and the number of leads with fQRS. The number of leads with fQRS was the only predictor of response to CRT (odds ratio: 0.61, 95% confidence interval: 0.48-0.77, P < 0.001).


CONCLUSIONS
The more leads with fQRS predicts nonresponse to CRT and may help in the selection of CRT candidates.
Department of Cardiology, Kocaeli University, Kocaeli, Turkey. ycelikyurt@gmail.com
Umut
U
Celikyurt
Aysen
A
Agacdiken
Tayfun
T
Sahin
Neslihan
N
Al
Guliz
G
Kozdag
Ahmet
A
Vural
Dilek
D
Ural
D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D004562:Electrocardiography; D004566:Electrodes / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D016277:Ventricular Function, Left