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Prolonged QRS and QTc interval and mortality

Institute of Cardiology, University of Bologna, Italy

Correspondence to:
Dr F Grigioni, Institute of Cardiology, University of Bologna, via Massarenti, 9 Bologna, 40138 Italy; francesco.grigioni@unibo.it

The first 150 words of the full text of this article appear below.

To the editor: Breidthardt et al¹ found that patients with acute decompensated heart failure (HF) presenting to their emergency department with prolonged QRS interval (120 ms) showed higher long-term mortality.

This is a pathophysiologically plausible finding: after initially representing a marker of diseased myocardium, prolonged QRS may itself subsequently contribute to disease progression.² Nevertheless, we cannot totally agree with the clinical implication the authors make about use of this particular ECG measure for clinical management of acute HF. The concept that QRS measurement might help guide rapid intensive care modalities is attractive. However, patients with prolonged QRS interval at the time of admission to the emergency department did not show significant differences in 30-day mortality (p = 0.27) or length of hospital stay (p = 0.32). Therefore, the present study provides little direct evidence that prolonged QRS interval at presentation affects outcome in the acute phase of HF, and . . . [Full text of this article]