PMID- 19614634
OWN - NLM
STAT- MEDLINE
DCOM- 20091029
LR  - 20211020
IS  - 1542-474X (Electronic)
IS  - 1082-720X (Print)
IS  - 1082-720X (Linking)
VI  - 14
IP  - 3
DP  - 2009 Jul
TI  - Correlation of mechanical dyssynchrony with QRS duration measured by 
      signal-averaged electrocardiography.
PG  - 234-41
LID - 10.1111/j.1542-474X.2009.00303.x [doi]
AB  - BACKGROUND: Preimplantation left ventricular dyssynchrony is considered a 
      prerequisite for a beneficial response to cardiac resynchronization therapy 
      (CRT). However, electrical dyssynchrony estimated by QRS duration (QRSd) on ECG 
      has not been proven to be an optimal surrogate of mechanical dyssynchrony. We 
      evaluated the correlation of mechanical dyssynchrony with QRSd as measured by 
      signal-averaged electrocardiography (SAECG) in comparison with measurements based 
      on conventional surface ECG and with onscreen measurements based on digital ECG. 
      METHODS: We included 49 consecutive patients with decompensated heart failure (40 
      men, aged 66.8 +/- 9.5 years), New York Heart Association (NYHA) class II-IV, and 
      LVEF < or = 40%. QRSd was calculated by manual measurement of 12-lead ECG, 
      on-screen measurement of computer-based ECG, and calculation of total ventricular 
      activation time on SAECG. RESULTS: Only 60.4% of the studied patients had QRS > 
      or = 120 ms based on measurements derived by SAECG compared to 69.4% by using 
      on-screen measurement of computer-based ECG and 73.5% based on surface ECG 
      (P=0.041). Interventricular but not intraventricular delay was correlated with 
      QRSd. The correlation of interventricular dyssynchrony with QRSd was stronger 
      when measured by SAECG than by surface ECG (r=0.45, P=0.001 vs r=0.35, P < 0.01). 
      Among patients with ischemic cardiomyopathy, no significant correlation was 
      demonstrated between mechanical dyssynchrony and QRSd. In nonischemic patients, 
      interventricular delay was significantly correlated with QRSd measured by surface 
      ECG (r=0.45, P < 0.05) and SAECG (r=0.46, P < 0.05). CONCLUSIONS: The use of 
      SAECG results in different patient classification in wide QRS complex category as 
      compared to surface ECG. Furthermore, QRSd measured by SAECG is correlated with 
      interventricular but not intraventricular dyssynchrony in heart failure patients.
FAU - Andrikopoulos, George K
AU  - Andrikopoulos GK
AD  - First Department of Cardiology, Evagelismos General Hospital, Athens, Greece. 
      andrikop@hotmail.com
FAU - Tzeis, Stylianos
AU  - Tzeis S
FAU - Kolb, Christof
AU  - Kolb C
FAU - Sakellariou, Dimitrios
AU  - Sakellariou D
FAU - Avramides, Dimosthenes
AU  - Avramides D
FAU - Alexopoulos, Evangelos C
AU  - Alexopoulos EC
FAU - Triantafyllou, Konstantinos
AU  - Triantafyllou K
FAU - Manolis, Antonis S
AU  - Manolis AS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ann Noninvasive Electrocardiol
JT  - Annals of noninvasive electrocardiology : the official journal of the 
      International Society for Holter and Noninvasive Electrocardiology, Inc
JID - 9607443
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Chi-Square Distribution
MH  - Echocardiography
MH  - Electrocardiography/*methods
MH  - Female
MH  - Heart Conduction System/*physiopathology
MH  - Heart Failure/diagnostic imaging/*physiopathology
MH  - Humans
MH  - Male
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*physiopathology
PMC - PMC6932484
EDAT- 2009/07/21 09:00
MHDA- 2009/10/30 06:00
PMCR- 2009/07/09
CRDT- 2009/07/21 09:00
PHST- 2009/07/21 09:00 [entrez]
PHST- 2009/07/21 09:00 [pubmed]
PHST- 2009/10/30 06:00 [medline]
PHST- 2009/07/09 00:00 [pmc-release]
AID - ANEC303 [pii]
AID - 10.1111/j.1542-474X.2009.00303.x [doi]
PST - ppublish
SO  - Ann Noninvasive Electrocardiol. 2009 Jul;14(3):234-41. doi: 
      10.1111/j.1542-474X.2009.00303.x.