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A new simplified el...
A new simplified electrocardiographic score predicts clinical outcome in patients treated with CRT
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- Végh, Eszter M (author)
- Massachusetts General Hospital
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- Kandala, Jagdesh (author)
- Massachusetts General Hospital
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- Januszkiewicz, Lukasz (author)
- Massachusetts General Hospital
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- Ren, Jen (author)
- Massachusetts General Hospital
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- Miller, Alexandra (author)
- Massachusetts General Hospital
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- Orencole, Mary (author)
- Massachusetts General Hospital
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- Blendea, Dan (author)
- Massachusetts General Hospital
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- Merkely, Béla (author)
- Semmelweis University
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- Gellér, László (author)
- Semmelweis University
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- Singh, Jagmeet P (author)
- Massachusetts General Hospital
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- Borgquist, Rasmus (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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(creator_code:org_t)
- 2017-02-04
- 2018
- English.
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In: Europace. - : Oxford University Press (OUP). - 1532-2092. ; 20:3, s. 492-500
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Abstract
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- Aims Cardiac Resynchronization Therapy (CRT) reduces morbidity and mortality for patients with heart failure and wide QRS complex, but up to 1/3 of patients are "non-responders" to the therapy. This study examines the ability of a simple standard electrocardiogram (ECG)-based scoring system to predict clinical outcome. Methods and results Four hundred and ninety-one consecutive patients with CRT-implants (79% males, mean age 71 years, LVEF 24%, 59% with ischemic cardiomyopathy, 83% in NYHA class III) were included from a single large volume centre. All patients met standard indications for CRT, and were followed for 3 years after CRT implantation. Three ECG parameters were measured on the post-implant ECG, and compared to pre-implantation measurements: QRS duration, time to intrinsicoid deflection onset (ID) in V1 lead, amplitude change in V1 lead. Each positive ECG variable was given a numerical value of 1 to create the score (ranging 0–3). Clinical outcome was assessed as a composite of all-cause death, left ventricular assist device implantation, cardiac transplantation and HF hospitalization. Event-free survival was predicted by shortening of QRS duration ≥20 ms (HR 0.66 [95% CI 0.48–0.90] P = 0.009), ≥50% decreased summed R + S amplitude in V1 lead (HR 0.67 [0.49–0.90] P = 0.009) and ≤40 msec ID time in lead V1 during pacing (HR 0.63 [0.46–0.86] P = 0.004). The total score was an independent predictor for both event-free survival (HR 0.65 [0.54–0.77] P < 0.001) and for ≥10% left ventricular ejection fraction improvement (OR 1.7 [1.3–2.3] P < 0.001). Conclusions Composite data from 12-lead ECG during CRT-treatment can be used in a simple score to predict long-term clinical outcome.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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Europace
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- By the author/editor
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Végh, Eszter M
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Kandala, Jagdesh
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Januszkiewicz, L ...
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Ren, Jen
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Miller, Alexandr ...
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Orencole, Mary
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show more...
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Blendea, Dan
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Merkely, Béla
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Gellér, László
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Singh, Jagmeet P
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Borgquist, Rasmu ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Europace
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EP Europace
- By the university
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Lund University