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Cardiac resynchronization therapy (CRT) is a well-established, ef cient strategy for medically-refractory congestive heart failure (HF) with ventricular conduction disturbances. However, about 30% of patients who undergo CRT do not receive any bene t. Therefore, we investigated the usefulness of the QRS-left ventricle (LV) interval for predicting responders during CRT implantation. This study included 66 patients who underwent CRT implantation. The de nition of responder was a ≥ 15% reduction in LV end-systolic volume or ≥ 20% increase in LV ejection fraction. The QRS-LV interval was measured from the beginning of the body surface electrocardiogram QRS complex to the LV potential recorded by LV leads. We analyzed the correlations between the QRS-LV intervals and CRT responders, admission for HF and mortality. The patients were 67 ± 12 years old, and their mean LV ejection fraction was 26.3%± 8.3% . During follow-up (27.2 ± 19.9 months), 27 patients were admitted for HF (40.1%), and 17 died (25.7%); the median QRS-LV interval was 103 ± 33 msec. Patients were divided into 2 groups: wide QRS-LV (> 103 msec), and narrow QRS-LV (< 103 msec). The wide QRSLV group had a lower mortality rate than the narrow QRS-LV group (77% vs. 53%, P < 0.05). In patients with dilated cardiomyopathy, the QRS-LV interval was signi cantly wider in responders, compared to non-responders (112 ± 9.2 vs. 80.0 ± 10 msec, P< 0.05). The QRS-LV interval did not correlate with CRT responders or admission for HF. The mortality rate was lower in patients with wide QRSLV intervals, compared to narrow QRS-LV intervals. Furthermore, a wide QRS-LV interval might be a predictor for CRT responders in patients with dilated cardiomyopathy.

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy