QRS prolongation after cardiac resynchronization therapy is a predictor of persistent mechanical dyssynchrony

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dc.authorid0000-0002-4281-0867
dc.authorid0000-0003-2995-8792
dc.authorid0000-0003-0230-6575
dc.authorid0000-0003-2714-4584
dc.contributor.authorKaraca, Oğuz
dc.contributor.authorOmaygenç, Onur
dc.contributor.authorÇakal, Beytullah
dc.contributor.authorÇakal Deniz, Sinem
dc.contributor.authorBarutçu, İrfan
dc.contributor.authorBoztosun, Bilal
dc.contributor.authorKılıçaslan, Fethi
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:58:22Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:58:22Z
dc.date.issued2016
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.descriptionWOS: 000384843600005
dc.descriptionPubMed ID: 26621183
dc.description.abstractPurpose Prolonged QRS duration is the main selection criterion for cardiac resynchronization therapy (CRT) which ameliorates left ventricular mechanical dyssynchrony (MD). However, consequences of post-CRT QRS prolongation and residual MD have been poorly evaluated. We aimed to define the predictors of persistent MD and hypothesized that CRT-induced QRS change (Delta QRS) might have an impact on residual MD after CRT. Methods A total of 80 patients receiving CRT were included in the study. Delta QRS was calculated as the difference between the baseline and paced QRS intervals. Residual MD was assessed early after device implantation with a longitudinal dyssynchrony index (Yu index). Significant MD was defined as a Yu index >= 33 msec. Two groups were created based on residual MD and compared according to clinical, electrocardiographic and echocardiographic features. Results Patients with persistent MD had longer paced QRS durations (182.5 +/- 16.2 vs. 165.4 +/- 22.5 msec, p= 0.03) and were less likely to have left ventricular (LV) leads located in the posterolateral vein (53 % vs. 85 %, p= 0.002). The linear correlation between the Delta QRS and the Yu index values was modest (Spearman's rho=-0.341, p= 0.002); additionally, a prolonged QRS was strongly associated with MD after CRT (p= 0.00008). Both LV lead localization and CRT-induced QRS prolongation emerged as the significant predictors of persistent MD. A biventricularly paced QRS more than 10 msec longer than the pre-paced QRS width was predictive of persistent MD after CRT (sensitivity= 80 %, specificity= 62 %). Conclusions Delta QRS was found to be associated with residual MDafter CRT. Ten milliseconds of QRS prolongation predicted persistent MD after CRT.
dc.identifier.citationKaraca, O., Omaygenç, O., Çakal, B., Çakal Deniz, S., Barutçu, İ., Boztosun, B. ... Kılıçaslan, F. (2016). QRS prolongation after cardiac resynchronization therapy is a predictor of persistent mechanical dyssynchrony. Journal Of Interventional Cardiac Electrophysiology, 46(2), 105-113. https://dx.doi.org/10.1007/s10840-015-0080-7
dc.identifier.doi10.1007/s10840-015-0080-7
dc.identifier.endpage113
dc.identifier.issn1383-875X
dc.identifier.issn1572-8595
dc.identifier.issue2
dc.identifier.scopusqualityQ1
dc.identifier.startpage105
dc.identifier.urihttps://dx.doi.org/10.1007/s10840-015-0080-7
dc.identifier.urihttps://hdl.handle.net/20.500.12511/3156
dc.identifier.volume46
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofJournal Of Interventional Cardiac Electrophysiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCardiac Resynchronization Therapy
dc.subjectPaced QRS
dc.subjectQRS Prolongation
dc.subjectMechanical Dyssynchrony
dc.titleQRS prolongation after cardiac resynchronization therapy is a predictor of persistent mechanical dyssynchrony
dc.typeArticle

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