PMID- 27346260
OWN - NLM
STAT- MEDLINE
DCOM- 20161216
LR  - 20181202
IS  - 0253-3758 (Print)
IS  - 0253-3758 (Linking)
VI  - 44
IP  - 6
DP  - 2016 Jun 24
TI  - [Role of electrocardiogram in predicting cardiac resynchronization therapy 
      response].
PG  - 483-8
LID - 10.3760/cma.j.issn.0253-3758.2016.06.006 [doi]
AB  - OBJECTIVE: To explore the role of electrocardiogram(ECG)in predicting cardiac 
      resynchronization therapy (CRT) response. METHODS: This study retrospectively 
      analyzed ECG of 92 CRT patients, who received CRT therapy from 2001 to 2013 in 
      our center and were followed up for 6 months. The patients were divided into 
      responder group (n=64) and non-responder group (n=28). The baseline and 6-month 
      data including QRS width, heart rhythm and axis variation were analyzed. The 
      definition of responder is left ventricular end systolic volume (LVESV) reduction 
      >/=15% within 6 months after CRT. After CRT therapy, the ventricular activation was 
      changed as left to right (frontal plane), posterior to anterior and axis changed 
      in a clockwise direction. The change in more than two directions was defined as 
      prominent axis change. Logistic analysis was performed to analyze the role of ECG 
      in predicting CRT response. RESULTS: (1) Baseline parameter comparison between 
      the two groups: the proportion of female and LBBB is significantly higher 
      (P<0.01; P=0.04), while the proportion of atrial fibrillation/flutter (Af/AF) is 
      significantly lower (P<0.01) in responder group than in non-responder group. The 
      pre-CRT average QRS duration is much wider in responder group than in 
      non-responder group (P=0.01). (2) Comparison of follow-up with baseline results 
      in two groups: NYHA heart function level, 6 minutes walking distance, QRS 
      duration, LVEF, LVESV improved significantly (P<0.01) post-CRT in responder 
      group. In non-responder group, the QRS duration and LVESV deteriorated 
      significantly (P=0.02, P<0.01), while post-CRT NYHA heart function level improved 
      significantly. In responder group, pre-CRT ECG axis of 53 patients (82.8%) 
      pointed to left and 58 patients (90.6%) pointed to posterior; post-CRT ECG axis 
      of 49 patients (76.6%) pointed to right and 30 patients (40.6%) pointed to 
      anterior. In non-responder group, pre-CRT ECG axis of 25 patients (89.3%) pointed 
      to left and 24 patients (85.7%) pointed to posterior; post-CRT ECG axis of 17 
      patients (60.7%) pointed to right and 12 patients (42.9%) pointed to anterior. 
      Post-CRT, the proportion of ECG axis prominent change was significantly higher in 
      responder than in non-responder group (62.5%(40/64) vs. 32.1%(9/28), P=0.007). 
      (3)Predicting value: pre-CRT QRS width >/=140 ms (OR=4.97, 95% CI 1.53 to 16.13, 
      P=0.008)and post-CRT prominent axis change (OR=5.1, 95% CI 1.67 to 15.5, 
      P=0.004)were found to be independent predictors of CRT responders. Af/AF pre-CRT 
      was associated with reduced CRT response (OR=0.25, 95% CI 0.08 to 0.80, P=0.02). 
      CONCLUSIONS: ECG may play a role in predicting CRT response. QRS width and Af/AF 
      before CRT and ECG axis change post-CRT could be used to predict CRT response.
FAU - Guo, J P
AU  - Guo JP
AD  - Department of Cardiology, Chinese People's Liberation Army General Hospital, 
      Beijing 100853, China.
FAU - Wang, Y T
AU  - Wang YT
FAU - Shan, Z L
AU  - Shan ZL
FAU - Shi, X M
AU  - Shi XM
FAU - Lin, K
AU  - Lin K
FAU - Yuan, H T
AU  - Yuan HT
FAU - Li, J
AU  - Li J
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Xin Xue Guan Bing Za Zhi
JT  - Zhonghua xin xue guan bing za zhi
JID - 7910682
SB  - IM
MH  - Atrial Fibrillation/diagnosis
MH  - *Cardiac Resynchronization Therapy
MH  - *Electrocardiography
MH  - Female
MH  - Heart Failure/*diagnosis/*therapy
MH  - Heart Ventricles
MH  - Humans
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2016/06/28 06:00
MHDA- 2016/12/17 06:00
CRDT- 2016/06/28 06:00
PHST- 2016/06/28 06:00 [entrez]
PHST- 2016/06/28 06:00 [pubmed]
PHST- 2016/12/17 06:00 [medline]
AID - 10.3760/cma.j.issn.0253-3758.2016.06.006 [doi]
PST - ppublish
SO  - Zhonghua Xin Xue Guan Bing Za Zhi. 2016 Jun 24;44(6):483-8. doi: 
      10.3760/cma.j.issn.0253-3758.2016.06.006.