Predicting ventricular arrhythmias in cardiac resynchronization therapy: The impact of persistent electrical dyssynchrony
View/ Open
Access
info:eu-repo/semantics/embargoedAccessDate
2016Author
Karaca, OğuzGüneş, Hacı Murat
Omaygenç, Mehmet Onur
Çakal, Beytullah
Çakal Deniz, Sinem
Demir, Gültekin Günhan
Kızılırmak, Filiz
Gökdeniz, Tayyar
Barutçu, İrfan
Boztosun, Bilal
Kılıçaslan, Fethi
Metadata
Show full item recordCitation
Karaca, O., Güneş, H. M., Omaygenç, M. O., Çakal, B., Çakal Deniz, S., Demir, G. G. ... Kılıçaslan, F. (2016). Predicting ventricular arrhythmias in cardiac resynchronization therapy: The impact of persistent electrical dyssynchrony. Pace-Pacing And Clinical Electrophysiology, 39(9), 969-977. https://dx.doi.org/10.1111/pace.12908Abstract
BackgroundAlthough response to cardiac resynchronization therapy (CRT) has been conventionally assessed with left ventricular volume reduction, ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) are of critical importance associated with unfavorable outcomes even in the superresponders to therapy. We evaluated the predictors of VT/VF and the association of residual dyssynchrony during follow-up. MethodsNinety-five patients receiving CRT were followed-up for 9 3 months. Post-CRT dyssynchrony was defined as a prolonged QRS duration (QRSd) for persistent electrical dyssynchrony (ED), and a Yu index 33 ms for persistent mechanical dyssynchrony. The first VT/VF episode, including nonsustained VT detected on device interrogation and/or appropriate antitachycardia pacing or shock for VT/VF, were the end points of the study. ResultsForty-five patients who reached the study end points had significantly lower mean QRS (baseline QRSd - post-CRT QRSd) values than those without VT/VF (-20.8 +/- 28.9 ms vs -6.6 +/- 30.7 ms, P = 0.022). Both the baseline and post-CRT QRSds, along with the Yu index values, were not different in two groups. Patients with VT/VF were statistically more likely to have persistent ED (38% vs 9%, P = 0.021). Kaplan-Meier curves showed that a negative QRS was associated with a higher incidence of VT/VF during follow-up (P = 0.016). A multivariate Cox model revealed that QRS prolongation was an independent predictor of VT/VF after CRT (P = 0.029). ConclusionsA negative QRS, also called persistent ED, is associated with VT/VF. Narrowest possible QRSd might be a reliable goal of both implantation and optimization of devices to reduce arrhythmic events after CRT.
WoS Q Kategorisi
Q4xmlui.dri2xhtml.METS-1.0.item-scopusquality
Q2Source
Pace-Pacing And Clinical ElectrophysiologyVolume
39Issue
9Collections
- Makale Koleksiyonu [3642]
- PubMed İndeksli Yayınlar Koleksiyonu [4039]
- Scopus İndeksli Yayınlar Koleksiyonu [6274]
- WoS İndeksli Yayınlar Koleksiyonu [6417]