RT Journal Article
SR Electronic
T1 Effects of cardiac resynchronisation therapy in patients with heart failure having a narrow QRS Complex enrolled in PROSPECT
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1107
OP 1113
DO 10.1136/hrt.2010.192542
VO 96
IS 14
A1 R J van Bommel
A1 J Gorcsan III
A1 E S Chung
A1 W T Abraham
A1 F T Gjestvang
A1 C Leclercq
A1 M J Monaghan
A1 P Nihoyannopoulos
A1 C Peraldo
A1 C-M Yu
A1 M Demas
A1 B Gerritse
A1 J J Bax
YR 2010
UL http://heart.bmj.com/content/96/14/1107.abstract
AB Introduction Current guidelines recommend cardiac resynchronisation therapy (CRT) in patients with severe symptomatic heart failure, depressed left ventricular (LV) systolic function and a wide QRS complex (≥120 ms). However, patients with heart failure having a narrow QRS complex might also benefit from CRT.Design setting patients interventions During the Predictors of Response to Cardiac Resynchronisation Therapy (PROSPECT) trial, 41 patients were enrolled in a ‘narrow’ QRS sub-study. These patients had a QRS complex <130 ms, but documented evidence of mechanical dyssynchrony by any of seven pre-defined echocardiographic measures.Results After 6 months of CRT, 26 (63.4%) patients showed improvement according to the Clinical Composite Score, 4 (9.8%) remained unchanged and 11 (26.8%) worsened. In patients with paired data, the 6-min walking distance increased from 334±118 m to 382±128 m, (p=0.003) and quality-of-life score improved from 44.2±19.7 to 26.8±20.2 (p<0.0001). Furthermore, there was a significant decrease in LV end-systolic diameter (from 59±9 to 55±12 mm, p=0.002) and in LV end-diastolic diameter (from 67±9 to 63±11 mm, p=0.007).Conclusion The results suggest that CRT may have a beneficial effect in heart failure patients with a narrow QRS complex and mechanical dyssynchrony as assessed by echocardiography. The majority of patients improved on clinical symptoms, and there was an evident reduction in LV diameters. Larger studies are needed to clearly define selection criteria for CRT in patients with a narrow QRS complex.