Predictive Power of the Baseline QRS Complex Duration for Clinical Response to Cardiac Resynchronisation Therapy

10.5083/ejcm.20424884.42 , Cite or Link Using DOI
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Ali Kazemisaeid, Ali Bozorgi, Ahmad Yamini Sharif, Gholamreza Davoodi, Saeed Sadeghian, Enseyeh Dogmehchi, Hakimeh Sadeghian, Mehrdad Sheikhvatan


Determination of predictors of response to cardiac resynchronisation therapy (CRT) in patients with moderate to severe heart failure accompanied by a ventricular dyssynchrony can play a major role in improving candidate selection for CRT.

Objectives: We evaluated whether the baseline QRS duration could be used to discriminate responders from non-responders to CRT.

Methods: Eighty-three consecutive patients with moderate to severe heart failure and with successful implantation of a CRT device at our centre were included in the study. QRS durations were measured on 12-lead surface electrocardiogram before and 6 months after implantation of the CRT device, using the widest QRS complex in leads II, V1 and V6. Clinical response to CRT was defined as an improvement of ≥1 grade in NYHA class.

Results: Optimal cut-off value to discriminate baseline QRS duration for predicting clinical response to CRT was identified at 152 ms, yielding a sensitivity of 73.3%, a specificity of 56.5% as well as positive and negative predictive values of 81.5% and 44.8%, respectively. The discriminatory power of the baseline QRS duration for response to CRT assessed by the ROC curve was 0.6402 (95% CI: 0.4976 – 0.7829). Baseline QRS duration ≥ 152 ms could effectively predict clinical response to CRT after adjusting for covariates (OR = 3.743, p = 0.017).

Conclusion: Baseline QRS duration can effectively predict clinical response to CRT and optimal cut-off value to discriminate baseline QRS duration for response to CRT is 152 ms.