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

ORIGINAL ARTICLE, February 2011, VOL I ISSUE III, ISSN 2042-4884
10.5083/ejcm.20424884.36 , Cite or Link Using DOI
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Ali Kazemisaeid, MD, Ali Bozorgi, MD, Ahmad Yamini Sharif, MD, Gholamreza Davoodi, MD, Saeed Sadeghian, MD, Hakimeh Sadeghian, MD, Enseyeh Dogmehchi MD & Mehrdad Sheikhvatan, MD

Background:

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.