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Selection of Patient for Cardiac Resynchronization Therapy: Role of QT Corrected Dispersion
Author(s) -
TIMINERI SALVATORE,
MULÈ MASSIMILIANO,
PUZZANGARA EUGLENA,
SANTANGELO GLORIA,
DUGO DANIELA,
SCHILLACI VINCENZO,
DI GRAZIA ANGELO,
LIOTTA CAUDIO,
SCANDURA SALVATORE,
TEMPIO DONATELLA,
TAMBURINO CORRADO,
CALVI VALERIA
Publication year - 2012
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.1540-8159.2012.03402.x
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , qrs complex , ejection fraction , heart failure
Aims: About 30 to 50% of patients undergoing cardiac resynchronization therapy (CRT) may not show clinical or echocardiographic improvement, despite fulfilling guidelines recommendations for CRT. For this reason, we need a more accurate method to assess CRT eligibility. The aims of this study were to verify, on a 12‐month follow‐up, the usefulness of QT corrected dispersion (QTcD) in a patient's selection for CRT.Methods: We stratified 53 patients who underwent CRT, into two groups based on the estimation of QTcD, that is, QTcD > 60 ms and QTcD ≤ 60 ms. In all patients were performed New York Heart Association (NYHA) class determination, six‐minute walking test, QtcD, and QRS measurements, and complete echocardiographic assessment at 1, 3, 6, and 12 months after implantation.Results: At baseline, there were no significant differences in clinical, echocardiographic, and electrocardiographic parameters duration between two groups. At 12‐month follow‐up between the two groups, there were significant differences in NYHA (1.2 ± 0.4 vs 2 ± 0.6; P < 0.01), six‐minute walking distance (422 ± 68 vs 364 ± 68; P < 0.01), left ventricular (LV) ejection fraction (34 ± 7% vs 28 ± 6%; P < 0.01), LV end‐diastolic diameter (57 ± 7 vs 63 ± 8; P < 0.01), and LV intraventricular dyssynchrony (24 ± 14 vs 39 ± 23; P < 0.01).Conclusion:This study suggests that QTc dispersion in addition to QRS duration could improve the sensitivity of electrocardiogram in a patient's selection for CRT. (PACE 2012;1–6)