BACKGROUND: Cardiac resynchronization therapy (CRT) is recommended in patients with ejection fraction <35%, QRS width> 120 ms, and New York Heart Association (NYHA) functional class III or IV despite optimal medical therapy. We aimed to define demographic, clinical, and electrocardiographic predictors of positive clinical response to CRT. METHODS AND RESULTS: Hundred consecutive patients fulfilling the recommended criteria were implanted with a CRT device. Demographic, clinical, two-dimensional echocardiographic and electrographic parameters were measured at baseline and after 6 months of simultaneous biventricular pacing. A positive response to CRT included an improvement of at least one NYHA functional class associated with an absence of hospitalization for worsening heart failure. At the end of follow-up, 12 patients were dead and 71% of the patients were classified as responders. After 6 months of CRT, the ejection fraction was significantly higher (P = 0.035) in responders versus nonresponders. Multivariate analysis identified three independent predictors of positive response to CRT: an idiopathic origin of the cardiomyopathy (P = 0.043), a wider QRS before implantation (P = 0.017), and a narrowing of the QRS after implantation (P = 0.037). CONCLUSION: An idiopathic origin of the cardiomyopathy, a wider QRS before implantation, and a narrowing of the QRS width after implantation were identified as independent predictors of clinical positive response to CRT.
BACKGROUND: Cardiac resynchronization therapy (CRT) is recommended in patients with ejection fraction <35%, QRS width> 120 ms, and New York Heart Association (NYHA) functional class III or IV despite optimal medical therapy. We aimed to define demographic, clinical, and electrocardiographic predictors of positive clinical response to CRT. METHODS AND RESULTS: Hundred consecutive patients fulfilling the recommended criteria were implanted with a CRT device. Demographic, clinical, two-dimensional echocardiographic and electrographic parameters were measured at baseline and after 6 months of simultaneous biventricular pacing. A positive response to CRT included an improvement of at least one NYHA functional class associated with an absence of hospitalization for worsening heart failure. At the end of follow-up, 12 patients were dead and 71% of the patients were classified as responders. After 6 months of CRT, the ejection fraction was significantly higher (P = 0.035) in responders versus nonresponders. Multivariate analysis identified three independent predictors of positive response to CRT: an idiopathic origin of the cardiomyopathy (P = 0.043), a wider QRS before implantation (P = 0.017), and a narrowing of the QRS after implantation (P = 0.037). CONCLUSION: An idiopathic origin of the cardiomyopathy, a wider QRS before implantation, and a narrowing of the QRS width after implantation were identified as independent predictors of clinical positive response to CRT.
Authors: Gorav Ailawadi; Damien J Lapar; Brian R Swenson; Cory D Maxwell; Micah E Girotti; James D Bergin; John A Kern; John P Dimarco; Srijoy Mahapatra Journal: Heart Rhythm Date: 2010-01-20 Impact factor: 6.343
Authors: Eduardo Arrais Rocha; Francisca Tatiana Moreira Pereira; José Sebastião Abreu; José Wellington O Lima; Marcelo de Paula Martins Monteiro; Almino Cavalcante Rocha Neto; Camilla Viana Arrais Goés; Ana Gardênia P Farias; Carlos Roberto Martins Rodrigues Sobrinho; Ana Rosa Pinto Quidute; Maurício Ibrahim Scanavacca Journal: Arq Bras Cardiol Date: 2015-08-07 Impact factor: 2.000
Authors: Andrew Crozier; Bojan Blazevic; Pablo Lamata; Gernot Plank; Matthew Ginks; Simon Duckett; Manav Sohal; Anoop Shetty; Christopher A Rinaldi; Reza Razavi; Nicolas P Smith; Steven A Niederer Journal: J Mol Cell Cardiol Date: 2015-11-04 Impact factor: 5.000