Martínez LF, Castañeda CO, Falcón RR, Castro HJA, Dorantes SM, Cruz CM, Mengana BA, Gutiérrez LA, de Zayas GJ, Quiñones MIR, Cabrera OM, de la Vega VK

Language: Portugués
References: 15
Page: 189-195
PDF size: 445.42 Kb.

ABSTRACT

Introduction: Cardiac resynchronization therapy (CRT) is an indication in heart failure with wide QRS and severely reduced left ventricular ejection fraction.
Objectives: To define the response predictors favorable to CRT.
Method: An observational, descriptive, retrospective study was conducted to evaluate the QRS index (difference between the QRS width before and after implantation, divided by its value before implantation, multiplied by 100) as a predictor of favorable response to CRT. Electrocardiograms were performed before the procedure, at 6 and 12 months after implantation. The measurements were made by two independent observers, the first digital on the operating room monitor and the rest manual.
Results: A total of 91 patients (mean age 61.2 years, 76% men) were included, with QRS wider than 120 ms and ejection fraction less than 35%. A favorable response was obtained in 59%. There were no significant pre-implant differences in the QRS duration between responders and non-responders (151.3 ms vs. 151.34 ms, p=0.98), but there were differences post-implant (100 vs. 115 ms, p<0.0001), as well as in the QRS percentage of decrease (33.2% vs. 24.3%, p<0.0001). The ROC curve showed that a cut-off value of the QRS index of 30% was sensitive (62%) and specific (75%) in order to predict a favorable response.
Conclusions: The decrease in the QRS width after the CRT implant is related to a favorable response to it.

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