PMID- 35686239
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 1735-3955 (Print)
IS  - 2251-6638 (Electronic)
IS  - 1735-3955 (Linking)
VI  - 17
IP  - 5
DP  - 2021 Sep
TI  - Lead one ratio: A new electrocardiogram marker for cardiac resynchronization 
      therapy response.
PG  - 1-8
LID - 10.22122/arya.v17i0.2247 [doi]
AB  - BACKGROUND: Wider QRS duration and presence of left bundle branch block (LBBB) 
      predict better cardiac resynchronization therapy (CRT) response. Despite strict 
      patient selection, one-third of patients have a sub-optimal response. We aim to 
      evaluate the impact of lead one ratio (LOR) on CRT response. METHODS: We enrolled 
      93 patients receiving CRT from August 2016 to August 2019. Pre-implant 12-lead 
      electrocardiogram (ECG) was recorded, and LOR was derived by dividing the maximum 
      positive deflection of QRS complex in ECG lead I by the maximum negative 
      deflection in lead I; cut-off value of 12 was used to divide the cohort into two 
      groups. Patients were followed for 6 months, and outcomes were compared for CRT 
      response, New York Heart Association (NYHA) class improvement, all-cause 
      mortality, and heart failure (HF) hospitalization events. RESULTS: At the end of 
      6-month follow-up, LOR >/= 12 was associated with significantly better CRT response 
      (75.76% vs. 51.85% in LOR < 12, P = 0.02), lower mortality per 100 patient-years 
      (9.09 vs. 14.81 in LOR < 12, P = 0.012), and more improvement in HF symptoms 
      (NYHA improvement) (78.79% vs. 55.56% in LOR < 12, P = 0.02). Patients with LOR < 
      12 had more HF hospitalization events (2.04 vs. 1.81 episodes in LOR >/= 12, P = 
      0.029) and less QRS narrowing (∆5.74 +/- 2.09 vs. ∆7.10 +/- 3.97 ms in LOR >/= 12, P = 
      0.01). QRS duration and LBBB morphology were predictors of response in both 
      groups of patients. CONCLUSION: LOR >/= 12 was associated with better response to 
      CRT, less HF hospitalization, and more relief in HF symptoms. This ratio helps to 
      identify possible sub-optimal response among patients with an indication for CRT.
CI  - (c) 2021 Isfahan Cardiovascular Research Center & Isfahan University of Medical 
      Sciences.
FAU - Raj, Ajay
AU  - Raj A
AD  - Department of Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences AND 
      Dr. Ram Manohar Lohia Hospital, New Delhi, India.
FAU - Nath, Ranjit Kumar
AU  - Nath RK
AD  - Department of Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences AND 
      Dr. Ram Manohar Lohia Hospital, New Delhi, India.
FAU - Pandit, Bhagya Narayan
AU  - Pandit BN
AD  - Department of Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences AND 
      Dr. Ram Manohar Lohia Hospital, New Delhi, India.
FAU - Singh, Ajay Pratap
AU  - Singh AP
AD  - Resident, Department of Cardiology, Atal Bihari Vajpayee Institute of Medical 
      Sciences AND Dr. Ram Manohar Lohia Hospital, New Delhi, India.
FAU - Pandit, Neeraj
AU  - Pandit N
AD  - Professor, Department of Cardiology, Atal Bihari Vajpayee Institute of Medical 
      Sciences AND Dr. Ram Manohar Lohia Hospital, New Delhi, India.
FAU - Aggarwal, Puneet
AU  - Aggarwal P
AD  - Assistant Professor, Department of Cardiology, Atal Bihari Vajpayee Institute of 
      Medical Sciences AND Dr. Ram Manohar Lohia Hospital, New Delhi, India.
LA  - eng
PT  - Journal Article
PL  - Iran
TA  - ARYA Atheroscler
JT  - ARYA atherosclerosis
JID - 101487337
PMC - PMC9137223
OTO - NOTNLM
OT  - Cardiac Resynchronization Therapy
OT  - Electrocardiography
OT  - Heart Failure
OT  - Left Bundle Branch Block
EDAT- 2022/06/11 06:00
MHDA- 2022/06/11 06:01
PMCR- 2021/09/01
CRDT- 2022/06/10 02:45
PHST- 2020/09/22 00:00 [received]
PHST- 2021/02/27 00:00 [accepted]
PHST- 2022/06/10 02:45 [entrez]
PHST- 2022/06/11 06:00 [pubmed]
PHST- 2022/06/11 06:01 [medline]
PHST- 2021/09/01 00:00 [pmc-release]
AID - ARYA-17-6-2247 [pii]
AID - 10.22122/arya.v17i0.2247 [doi]
PST - ppublish
SO  - ARYA Atheroscler. 2021 Sep;17(5):1-8. doi: 10.22122/arya.v17i0.2247.