Brett D Atwater1, Adefolakemi Babatunde2, Christopher Swan3, Bjorn Wieslander4, Abraham Andresen2, Dawn Rabineau2, Jennifer Tomfohr2, Galen Wagner5, Kevin P Jackson2, James P Daubert2. 1. Duke University Medical Center, Durham, North Carolina; Durham Veterans Administration Medical Center, Durham, North Carolina. Electronic address: brett.atwater@duke.edu. 2. Duke University Medical Center, Durham, North Carolina. 3. Stanford University, Palo Alto California. 4. Karolinska Institutet University Hospital, Stockholm, Sweden. 5. Duke University Medical Center, Durham, North Carolina; Duke Clinical Research Institute, Durham, North Carolina.
Abstract
INTRODUCTION: Electrocardiographic (ECG) LV scar quantification may improve prediction of CRT response. METHODS AND RESULTS: Data were abstracted in 76 patients who underwent a first CRT implantation at 2 US centers. Selvester QRS scar quantification was performed using the LBBB modified QRS scoring method. Seven clinical variables previously associated with reverse LV remodeling (RLVR) and QRS score were included in logistic regression analysis. Survival was compared across QRS score quartiles using Kaplan-Meier curves. RLVR occurred more frequently in patients with QRS score ≤ 5 (63%) than QRS score>5 (22%), (OR=5.83, 95% CI=2.11-16.07). After adjustment for clinical variables using logistic regression, QRS score>5 predicted RLVR (Chi-square=20.3, P=0.005, AUC=0.782). Patients in the lowest quartile of QRS score (<4) had improved survival compared to patients in the other QRS score quartiles (P=0.037). CONCLUSION: ECG quantified LV scar predicts RLVR and long-term survival in patients with LBBB undergoing CRT implantation.
INTRODUCTION: Electrocardiographic (ECG) LV scar quantification may improve prediction of CRT response. METHODS AND RESULTS: Data were abstracted in 76 patients who underwent a first CRT implantation at 2 US centers. Selvester QRS scar quantification was performed using the LBBB modified QRS scoring method. Seven clinical variables previously associated with reverse LV remodeling (RLVR) and QRS score were included in logistic regression analysis. Survival was compared across QRS score quartiles using Kaplan-Meier curves. RLVR occurred more frequently in patients with QRS score ≤ 5 (63%) than QRS score>5 (22%), (OR=5.83, 95% CI=2.11-16.07). After adjustment for clinical variables using logistic regression, QRS score>5 predicted RLVR (Chi-square=20.3, P=0.005, AUC=0.782). Patients in the lowest quartile of QRS score (<4) had improved survival compared to patients in the other QRS score quartiles (P=0.037). CONCLUSION: ECG quantified LV scar predicts RLVR and long-term survival in patients with LBBB undergoing CRT implantation.
Authors: Zak Loring; Brett D Atwater; Xiaojuan Xia; Jimmy Axelsson; Igor Klem; Robin Nijveldt; Erik B Schelbert; Jean-Philippe Couderc; David G Strauss; Martin Ugander; Björn Wieslander Journal: J Cardiovasc Electrophysiol Date: 2019-02-19
Authors: Björn Wieslander; Zak Loring; Wojciech Zareba; Scott McNitt; Galen S Wagner; James P Daubert; David G Strauss Journal: J Electrocardiol Date: 2016-05-02 Impact factor: 1.438