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Clinical Significance of QRS Duration During Ventricular Pacing
Author(s) -
SUMIYOSHI MASATAKA,
NAKATA YASURO,
TOKANO TAKASHI,
YASUDA MASAYUKI,
OHNO YASUHIKO,
HISAOKA TERUHIKO,
OGURA SHUNSUKE,
NAKAZATO YUJI,
YAMAGUCHI HIROSHI
Publication year - 1992
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1992.tb03099.x
Subject(s) - medicine , qrs complex , ejection fraction , cardiology , diastole , heart failure , blood pressure
To clarify the clinical significance of an abnormally prolonged paced QRS duration, we studied 114 patients who had undergone pacing for atrioventricular block (AVB). Patients were divided into two groups: group I consisted of 29 patients with at least one paced QRS duration ≥ 180 msec during the follow‐up period; group II consisted of 85 patients with paced QRS durations < 180 msec. The clinical background, QRS complexes before pacing, and the echocardiographic findings were assessed. Males (P < 0.05), those with H‐V block (P< 0.05) and a wider QRS complex of conducted and escape beats (both P < 0.01) were dominant in group I. The incidence of underlying heart disease was greater in group I than in group II (83% vs 32%, P < 0.01). Reduced left ventricular ejection fraction (LVEF) and increased left ventricular end‐diastolic dimension (LVDd) were more prominent in group I than in group II (LVEF 0.49 ± 0.17 vs 0.68 ± 0.10, P < 0.01, LVDd 57.1 ± 7.9 mm vs 48.5 ± 5.6 mm, P < 0.01). The paced QRS duration correlated with LVEF (r = ‐0.61) and LVDd (r = 0.81). A paced QRS duration ≥ 180 msec was sensitive and specific for a LVEF < 0.5 (83.3% and 85.2%) and LVDd ≥ 60 mm (100% and 81.4%). We conclude that patients with a prolonged paced QRS duration have more serious heart disease, and the paced QRS duration can be a useful indicator of impaired LV function.