| Correlation of mechanical dyssynchrony with QRS duration measured by signal-averaged electrocardiography. | |
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MedLine Citation:
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PMID: 19614634 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Preimplantation left ventricular dyssynchrony is considered a prerequisite for a beneficial response to cardiac resynchronization therapy (CRT). However, electrical dyssynchrony estimated by QRS duration (QRSd) on ECG has not been proven to be an optimal surrogate of mechanical dyssynchrony. We evaluated the correlation of mechanical dyssynchrony with QRSd as measured by signal-averaged electrocardiography (SAECG) in comparison with measurements based on conventional surface ECG and with onscreen measurements based on digital ECG. METHODS: We included 49 consecutive patients with decompensated heart failure (40 men, aged 66.8 +/- 9.5 years), New York Heart Association (NYHA) class II-IV, and LVEF < or = 40%. QRSd was calculated by manual measurement of 12-lead ECG, on-screen measurement of computer-based ECG, and calculation of total ventricular activation time on SAECG. RESULTS: Only 60.4% of the studied patients had QRS > or = 120 ms based on measurements derived by SAECG compared to 69.4% by using on-screen measurement of computer-based ECG and 73.5% based on surface ECG (P=0.041). Interventricular but not intraventricular delay was correlated with QRSd. The correlation of interventricular dyssynchrony with QRSd was stronger when measured by SAECG than by surface ECG (r=0.45, P=0.001 vs r=0.35, P < 0.01). Among patients with ischemic cardiomyopathy, no significant correlation was demonstrated between mechanical dyssynchrony and QRSd. In nonischemic patients, interventricular delay was significantly correlated with QRSd measured by surface ECG (r=0.45, P < 0.05) and SAECG (r=0.46, P < 0.05). CONCLUSIONS: The use of SAECG results in different patient classification in wide QRS complex category as compared to surface ECG. Furthermore, QRSd measured by SAECG is correlated with interventricular but not intraventricular dyssynchrony in heart failure patients. |
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Authors:
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George K Andrikopoulos; Stylianos Tzeis; Christof Kolb; Dimitrios Sakellariou; Dimosthenes Avramides; Evangelos C Alexopoulos; Konstantinos Triantafyllou; Antonis S Manolis |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc Volume: 14 ISSN: 1542-474X ISO Abbreviation: Ann Noninvasive Electrocardiol Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-20 Completed Date: 2009-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607443 Medline TA: Ann Noninvasive Electrocardiol Country: United States |
Other Details:
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Languages: eng Pagination: 234-41 Citation Subset: IM |
Affiliation:
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First Department of Cardiology, Evagelismos General Hospital, Athens, Greece. andrikop@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Chi-Square Distribution Echocardiography Electrocardiography / methods* Female Heart Conduction System / physiopathology* Heart Failure / physiopathology*, ultrasonography Humans Male Ventricular Dysfunction, Left / physiopathology*, ultrasonography |
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