Document Detail


QRS duration: a simple marker for predicting cardiac mortality in ICD patients with heart failure.
MedLine Citation:
PMID:  12975406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients resuscitated from ventricular tachyarrhythmias benefit from implantable cardioverter-defibrillators (ICDs) as opposed to medical treatment. Patients with increased QRS duration receiving an ICD in the presence of heart failure are at greatest risk of cardiac death and benefit most from ICD therapy.
OBJECTIVE: To determine whether an increased QRS duration predicts cardiac mortality in ICD recipients.
DESIGN: Consecutive patients with heart failure in New York Heart Association functional class III were grouped according to QRS duration (< 150 ms, n = 139, group 1; v > or = 150 ms, n = 26, group 2) and followed up for (mean (SD)) 23 (20) months.
PATIENTS: 165 patients were studied (80% men, 20% women); 73% had coronary artery disease and 18% had dilated cardiomyopathy. Their mean age was 62 (10) years and mean ejection fraction (EF) was 33 (14)%. They presented either with ventricular tachycardia (VT) or ventricular fibrillation (VF).
MAIN OUTCOME MEASURES: Overall and cardiac mortality; recurrence rates of VT, fast VT, or VF.
RESULTS: Mean left ventricular EF did not differ between group 1 (33 (13)%) and group 2 (31 (15)%). Forty patients died (34 cardiac deaths). There was no difference in survival between patients with EF > 35% and < or = 35%. Cardiac mortality was significantly higher in group 2 than in group 1 (31.3% at 12 months and 46.6% at 24 months, v 9.5% at 12 months and 18.2% at 24 months, respectively; p = 0.04). The recurrence rate of VT was similar in both groups.
CONCLUSIONS: Within subgroups at highest risk of cardiac death, QRS duration-a simple non-invasive index-predicts outcome in ICD recipients in the presence of heart failure.
Authors:
L Bode-Schnurbus; D Böcker; M Block; R Gradaus; A Heinecke; G Breithardt; M Borggrefe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  89     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-16     Completed Date:  2003-10-23     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1157-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology and Angiology and Institute for Research in Arteriosclerosis, Westfälische Wilhelms-University, Münster, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Death, Sudden, Cardiac / prevention & control
Defibrillators, Implantable*
Electrocardiography
Female
Heart Failure / mortality,  physiopathology,  therapy*
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Recurrence
Risk Factors
Stroke Volume / physiology
Survival Analysis
Ventricular Fibrillation / therapy*
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