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Publications

Mortality Reduction in LBBB Patients

Study Correlates CRT Induced QRS Narrowing to Mortality Reduction in Patients With LBBB

Marek Jastrzębski, Adrian Baranchuk, Kamil Fijorek, et al.

This study showed that with the initiation of CRT, immediate shortening of QRS duration in patients with LBBB strongly predicts favorable prognosis.

Despite the inclusion of other prognostically significant variables such as:

  • NYHA class
  • LVEF
  • LV end-diastolic dimension
  • Permanent AF
  • QRS duration
  • Age
  • Gender
  • HF aetiology
  • Creatinine level
  • Diabetes

QRS narrowing remained the most significant determinant of both mortality and combined endpoint of mortality and HF hospitalizations.

Significance of Electromechanical Dyssynchrony and QRS Narrowing for CRT Patients

Significance of Electromechanical Dyssynchrony and QRS Narrowing for CRT Patients

Ludovic Appert, MD, Aymeric Menet, MD, PhD, Alexandre Altes, MD, et al.

Clinical Significance of Electromechanical Dyssynchrony and QRS Narrowing in Patients with Heart Failure Receiving CRT

Results

  • 233 patients implanted with CRT between 2010 and 2014
  • 136 patients had electromechanical dyssynchrony amenable to CRT, and 118 of these experienced QRS narrowing after CRT
  • Lack of postoperative QRS narrowing was independently associated with an increased risk of cardiovascular mortality
  • 92% of patients with electromechanical dyssynchrony amenable to CRT experienced CRT response

QRS narrowing remained the most significant determinant of both mortality and combined endpoint of mortality and HF hospitalizations.

Conclusion

Postoperative QRS narrowing after CRT is linked to preoperative electromechanical dyssynchrony. Lack of postoperative QRS narrowing in patients without preoperative electromechanical dyssynchrony amenable to CRT is associated with very low rate of CRT response and a considerable increased risk of mortality during follow-up.

Programming CRT for Electrical Synchrony

Programming CRT for Electrical Synchrony: Reaching Beyond LBBB and LV Activation Delay

Niraj Varma, David O'Donnell, Mohammed Bassiouny, et al.

Results

  • 75 patients
  • QRS reduction:
    • Mode I: -11.8%
    • Mode II: -17.8%
    • Mode III: -23.9% (QRSd reduction 2x that of nominal BiV)
    • Mode IV: -15.6%

Conclusions

  • Nominal static CRT device settings have modest and sometimes detrimental effect.
  • SyncAV CRT settings reduced QRSd beyond nominal conventional CRT and eliminated the potential risk of QRS widening.