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EJIMA KOICHIRO
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Endowed Associate Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Narrowing filtered QRS duration on signal-averaged electrocardiogram predicts outcomes in cardiac resynchronization therapy patients with nonischemic heart failure. |
| Journal | Formal name：Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc Abbreviation：Ann Noninvasive Electrocardiol ISSN code：1082-720X/1542-474X |
| Domestic / Foregin | Foregin |
| Publisher | Wiley Periodicals Inc. |
| Volume, Issue, Page | 23(3),pp.e12523 |
| Author and coauthor | SUZUKI Atsushi†, SHIGA Tsuyoshi*, YAGISHITA Daigo, YAGISHITA Yoshimi, ARAI Kotaro, IWANAMI Yuji, EJIMA Koichiro, ASHIHARA Kyomi, SHODA Morio, HAGIWARA Nobuhisa |
| Publication date | 2018/05 |
| Summary | BACKGROUND:
To evaluate the impact of changes in the filtered QRS duration (fQRS) on signal-averaged electrocardiograms (SAECGs) from pre- to postimplantation on the clinical outcomes in nonischemic heart failure (HF) patients under cardiac resynchronization therapy (CRT). METHODS: We studied 103 patients with nonischemic HF and sinus rhythm who underwent CRT implantation. SAECGs were obtained within 1 week before and 1 week after implantation and narrowing fQRS was defined as a decrease in fQRS from pre- to postimplantation. Echocardiography was performed before and 6 months after CRT implantation. The primary outcome was death from any cause. The secondary outcomes were hospitalization due to worsened HF and occurrence of ventricular tachyarrhythmias. RESULTS: Of the 103 CRT patients, 53 (51%) showed narrowing fQRS. Left ventricular end-diastolic volume and end-systolic volume were significantly reduced (both p < .001), and the left ventricular ejection fraction was significantly increased (p < .001) after CRT in patients with narrowing fQRS, but not in patients with nonnarrowing fQRS. During a median follow-up period of 33 months, patients with narrowing fQRS exhibited better survival than patients with nonnarrowing fQRS (p = .007). A lower incidence of hospitalization due to worsened HF (p < .001) and a lower occurrence of ventricular tachyarrhythmias (p = .071) were obtained in patients with narrowing fQRS. After adjusting for confounding variables, narrowing fQRS was associated with a low risk of mortality (HR 0.27, p = .006). CONCLUSION: Our results suggested that narrowing fQRS on SAECG after CRT implantation predicts LV reverse remodeling and long-term outcomes in nonischemic HF patients. |
| DOI | 10.1111/anec.12523 |
| PMID | 29194868 |