PMID- 25921348
OWN - NLM
STAT- MEDLINE
DCOM- 20161031
LR  - 20181113
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 43
IP  - 2
DP  - 2015 Aug
TI  - Impact of baseline PR interval on cardiac resynchronization therapy outcomes in 
      patients with narrow QRS complexes: an analysis of the ReThinQ Trial.
PG  - 145-9
LID - 10.1007/s10840-015-9999-y [doi]
AB  - PURPOSE: Heart failure (HF) is a major cause of morbidity and mortality, and 
      ventricular dyssynchrony is an important contributor. The ReThinQ trial reported 
      no improvement with cardiac resynchronization therapy (CRT) in HF patients with 
      left ventricular ejection fraction (LVEF) <35%, narrow QRS (<130 ms), New York 
      Heart Association (NYHA) class III, and echocardiographically detected 
      dyssynchrony, in spite of echocardiographic optimization. We investigated whether 
      a subset of narrow QRS patients might derive benefit from CRT, based on baseline 
      PR interval. METHODS: We retrospectivelyanalyzed the 87 patients from ReThinQ who 
      were randomized to CRT. Patients were divided into two groups: baseline PR 
      interval <180 ms and baseline PR interval >/=180 ms. The primary outcome was change 
      in VO2 max at 6 months; secondary outcomes were change in LVEF, 6-min walk 
      distance, and change in NYHA class. RESULTS: Forty-six patients had PR < 180 ms 
      and 41 had PR >/= 180 ms. The baseline characteristics were similar in the two 
      groups. As compared to patients with a short PR interval, at 6 months, only 
      patients with PR >/= 180 ms showed a statistically significant increase in VO2 max 
      from 12.2 to 13.6 mL/kg min (P = 0.045). Similarly, LVEF was significantly 
      improved only in the long PR group (0.26 to 0.28, P = 0.038). A greater 
      percentage of patients in the long PR group showed improvement by at least one 
      NYHA class (59 vs. 35%, P = 0.033). CONCLUSIONS: A longer baseline PR interval 
      may allow more efficacious delivery of CRT by allowing programming of physiologic 
      AV delays. A short baseline PR interval may contribute to LV under-filling and 
      CRT non-response.
FAU - Joshi, Nikhil P
AU  - Joshi NP
AD  - Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, 
      USA.
FAU - Stopper, Matthew M
AU  - Stopper MM
FAU - Li, Jianqing
AU  - Li J
FAU - Beshai, John F
AU  - Beshai JF
FAU - Pavri, Behzad B
AU  - Pavri BB
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20150429
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - *Cardiac Resynchronization Therapy
MH  - Echocardiography
MH  - Exercise Test
MH  - Female
MH  - Heart Failure/diagnostic imaging/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Oxygen Consumption/physiology
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/diagnostic imaging/physiopathology/*therapy
EDAT- 2015/04/30 06:00
MHDA- 2016/11/01 06:00
CRDT- 2015/04/30 06:00
PHST- 2014/11/24 00:00 [received]
PHST- 2015/03/20 00:00 [accepted]
PHST- 2015/04/30 06:00 [entrez]
PHST- 2015/04/30 06:00 [pubmed]
PHST- 2016/11/01 06:00 [medline]
AID - 10.1007/s10840-015-9999-y [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2015 Aug;43(2):145-9. doi: 
      10.1007/s10840-015-9999-y. Epub 2015 Apr 29.