Value of Fragmented QRS in Predicting Prognosis of Patients after Cardiac Resynchronization Therapy

Huang SUN; Wei LUO; Mi-er MA; Hui-kai MU; Lei ZHONG; Xue-juan MA; Yun-zhu PENG; Rui-jie LI

doi:10.12259/j.issn.2095-610X.S20201111

Volume 41 Issue 11

Dec. 2020

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Huang SUN, Wei LUO, Mi-er MA, Hui-kai MU, Lei ZHONG, Xue-juan MA, Yun-zhu PENG, Rui-jie LI. Value of Fragmented QRS in Predicting Prognosis of Patients after Cardiac Resynchronization Therapy[J]. Journal of Kunming Medical University, 2020, 41(11): 38-43. doi: 10.12259/j.issn.2095-610X.S20201111

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Value of Fragmented QRS in Predicting Prognosis of Patients after Cardiac Resynchronization Therapy

doi: 10.12259/j.issn.2095-610X.S20201111

1.
Dept. of Cardiology，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Dept. of Echocardiography，Yan’an Hospital of Kunming，Kunming Yunnan 650051，China

Received Date: 2020-08-23
Publish Date: 2020-11-25

Abstract

Abstract

Objestive To investigate the association between characteristics of Fragmented QRS（fQRS）before and after CRT implantation and response to CRT. Methods Patients with heart failure planned for CRT were enrolled. The 12-lead ECGs before and after CRT were analyzed. The presence of fQRs was confirmed according to the definition in previous studies. Echocardiography imagines were obtained before and 6 months after the CRT implantation. Results The study included 108 patients（78 male, 72.2%）with a mean age of 56.5 ± 11.9 years. Totally 75 patients（69.4%）responded to CRT with significantly increased mean LVEF（from 30.71±1.92 to 50.61±2.57, P < 0.001）and decreased LVESV（from 195.26±78.79 to 156.55±84.44, P < 0.001）. After CRT implantation, the number of leads with fQRS remained unchanged in responders（6.25±2.68 vs. 6.03±2.54, P= 0.57 before and after CRT respectively）but increased in non-responders（6.18±2.20 vs.7.36±2.61, P = 0.013 before and after CRT respectively）. In the multivariate logistic analysis, a decreased number of leads with fQRS and shortened QRS duration immediately after CRT implantation was found to be a predictor of response to CRT. Conclusions In patients undergoing CRT, new fQRS as well as an increased number of leads with fQRS in 12-lead ECG immediately after CRT implantation predicts non-response to CRT and may help in the decision making in heart failure patients.
- Cardiac resynchronization therapy,
- Fragmented QRS,
- Non-response

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References

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