PMID- 15728648
OWN - NLM
STAT- MEDLINE
DCOM- 20050929
LR  - 20220408
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 26
IP  - 11
DP  - 2005 Jun
TI  - Clinical and electrocardiographic predictors of a positive response to cardiac 
      resynchronization therapy in advanced heart failure.
PG  - 1094-100
AB  - AIMS: Cardiac resynchronization therapy (CRT) is an effective treatment for 
      refractory congestive heart failure (CHF). However, up to 30% of patients do not 
      respond to CRT. The aim of this study was to identify clinical and 
      electrocardiographic (ECG) predictors of a positive response to CRT. METHODS AND 
      RESULTS: This retrospective study included 139 consecutive patients successfully 
      implanted with a CRT device (mean age, 68+/-9 years, 113 men). At baseline, 69% 
      of patients were in New York Heart Association (NYHA) functional class III, and 
      31% in class IV, mean left ventricular ejection fraction was 21+/-6%, and mean 
      QRS duration was 188+/-28 ms. In each patient, left and right ventricular leads 
      were placed to attain the shortest QRS duration during biventricular stimulation. 
      Patients were classified at 6 months as responders to CRT (n=100) if they were 
      alive, they had not been re-hospitalized for management of CHF, and the NYHA 
      class had decreased by 1 point, and/or peak VO(2) or 6 min hall-walk increased by 
      >10%. All others were classified as non-responders (n=38; one patient was lost to 
      follow-up). Uni- and multivariate logistic regression analyses were performed to 
      detect a pre- or intra-operative predictor of a positive response to CRT. Among 
      multiple demographic, clinical, and ECG variables, the amount of QRS shortening 
      (DeltaQRS) associated with biventricular stimulation was the only independent 
      predictor of a positive (37+/-23 ms) vs. negative (11+/-23 ms) response to CRT 
      (P<0.001). CONCLUSION: A positive response to CRT was observed in 73% of patients 
      at 6 months and predicted only by DeltaQRS.
FAU - Lecoq, Guillaume
AU  - Lecoq G
AD  - Department of Cardiology, Centre Hospitalier Universitaire, Rennes F-35000, 
      France.
FAU - Leclercq, Christophe
AU  - Leclercq C
FAU - Leray, Emmanuelle
AU  - Leray E
FAU - Crocq, Christophe
AU  - Crocq C
FAU - Alonso, Christine
AU  - Alonso C
FAU - de Place, Christian
AU  - de Place C
FAU - Mabo, Philippe
AU  - Mabo P
FAU - Daubert, Claude
AU  - Daubert C
LA  - eng
PT  - Journal Article
DEP - 20050223
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2005 Jun;26(11):1054-5. PMID: 15790581
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Chronic Disease
MH  - Electrocardiography
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Stroke Volume/physiology
MH  - Treatment Outcome
EDAT- 2005/02/25 09:00
MHDA- 2005/09/30 09:00
CRDT- 2005/02/25 09:00
PHST- 2005/02/25 09:00 [pubmed]
PHST- 2005/09/30 09:00 [medline]
PHST- 2005/02/25 09:00 [entrez]
AID - ehi146 [pii]
AID - 10.1093/eurheartj/ehi146 [doi]
PST - ppublish
SO  - Eur Heart J. 2005 Jun;26(11):1094-100. doi: 10.1093/eurheartj/ehi146. Epub 2005 
      Feb 23.