DIAGNOSTIC ACCURACY OF NUMBER OF FRAGMENTED QRS LEADS IN PREDICTION OF CARDIAC RESYNCHRONIZATION THERAPY RESPONSE IN PATIENTS WITH HEART FAILURE

Authors

  • Mohammad Assadian Rad Department of Cardiology, Healthy Heart Research Center, Dr. Heshmat Hospital, Guilan University of Medical Sciences, Rasht, Iran
  • Hassan Moladoust Department of Medical Physics, School of Medicine, Healthy Heart Research Center, Guilan University of Medical Sciences, Rasht, Iran
  • Asemeh Pourrajabi Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran http://orcid.org/0000-0001-7958-1546
  • Zohreh Heidarnezhad Department of Cardiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Amir Savarrakhsh Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran https://orcid.org/0000-0002-0904-6510

DOI:

https://doi.org/10.47144/phj.v55i4.2262

Abstract

Objectives: We investigated the diagnostic accuracy of fragmented QRS (fQRS) numbers in surface electrocardiogram (ECG) in heart failure (HF) patients for prediction of cardiac resynchronization therapy (CRT) non-responders.

Methodology: In this study, patients with HF who were candidates for CRT implantation were enrolled. A 12-lead surface electrocardiogram was conducted with the aim of finding fQRS. Presence of more than 2 notching in the R or S wave in wide QRS complexes in at least two adjacent leads corresponding to a coronary bed, considered as fQRS. All patients underwent transthoracic echocardiography 3-6 months after the CRT implantation for the evaluation of Left Ventricular End Diastolic Volume (LVEDV), Left Ventricular End Systolic Volume (LVESV), and Left ventricle ejection fraction (LVEF). The data were analyzed by SPSS v.22 software. P-value of less than 0.05 considered significant.

Results: We investigated on a total of 73 patients with HF that 64.38% of them responded to CRT. Most of responders were patients without fQRS complexes (80%). LVEF, LVESV, and LVEDV were different significantly before and after CRT implantation in patients with fQRS (p<0.001). Our results showed that the presence of at least one fQRS can lead to non-responsiveness to CRT. Therefore, we take cut-off point equal-greater than one into account as the best cut-off point for response to CRT. The area under the curve (AUC) for CRT prediction was 0.715 (95% CI: 0.598-0.815, P=0.003).

Conclusion: In conclusion, the presence of even one fQRS in the surface ECG can predict CRT non-responsiveness with good accuracy.

Downloads

Download data is not yet available.

Downloads

Published

2022-12-31

How to Cite

1.
Assadian Rad M, Moladoust H, Pourrajabi A, Heidarnezhad Z, Savarrakhsh A. DIAGNOSTIC ACCURACY OF NUMBER OF FRAGMENTED QRS LEADS IN PREDICTION OF CARDIAC RESYNCHRONIZATION THERAPY RESPONSE IN PATIENTS WITH HEART FAILURE. Pak Heart J [Internet]. 2022Dec.31 [cited 2024Nov.24];55(4):341-5. Available from: https://pakheartjournal1.pcs.org.pk/index.php/pk/article/view/2262

Issue

Vol. 55 No. 4 (2022): Pakistan Heart Journal

Section

Original Article

License

Copyright (c) 2022 Pakistan Heart Journal

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

When an article is accepted for publication in the print format, the author will be required to transfer exclusive copyright to the PHJ and retain the rights to use and share their published article with others. However, re-submission of the full article or any part for publication by a third party would require prior permission of the PHJ.

Online publication will allow the author to retain the copyright and share the article under the agreement described in the licensing rights with creative commons, with appropriate attribution to PHJ. Creative Commons attribution license CC BY 4.0 is applied to articles published in PHJ https://creativecommons.org/licenses/by/4.0/