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Cardiac Resynchronization Therapy in Patients With a Narrow QRS Complex

Gabe B. Bleeker, MD^_*,, Eduard R. Holman, MD, PhD^_*, Paul Steendijk, PhD^_*, Eric Boersma, PhD, Ernst E. van der Wall, MD, PhD^_*, Martin J. Schalij, MD, PhD^_* and Jeroen J. Bax, MD, PhD^_*,_*

^_* Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlandss
Interuniversity Cardiology Institute Netherlands (ICIN), Utrecht, the Netherlands
Department of Epidemiology and Statistics, Erasmus University, Rotterdam, the Netherlands

View larger version (27K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Left ventricular (LV) dyssynchrony before and 1 day after CRT implantation in patients with narrow QRS complex (<120 ms; n = 33) and in patients with wide QRS complex (120 ms; n = 33).

View larger version (90K): [in this window] [in a new window] [Download PPT slide]   Figure 2 (A) Color-coded tissue Doppler recordings in a heart failure patient with narrow QRS complex (96 ms), demonstrating a delay in peak systolic velocities of 85 ms (arrows indicate peak systolic velocity). (B) Color-coded tissue Doppler recordings in a patient with wide QRS complex (170 ms) illustrating a delay of 140 ms. The tissue Doppler tracings are obtained from samples placed in the basal part of the septum (yellow curve) and the lateral wall (green curve).

View larger version (12K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Improvements in clinical and echocardiographic parameters at 6 months' follow-up in patients with a narrow QRS complex (<120 ms). 6-min WT = 6-min walking test; LVEF = left ventricular ejection fraction; LVESV = left ventricular end-systolic volume; QoL = quality of life. *p < 0.05.

View larger version (14K): [in this window] [in a new window] [Download PPT slide]   Figure 4 No significant relationship existed between left ventricular (LV) dyssynchrony and QRS duration in the entire patient group (n = 66), both before implantation (A) and at 1 day after implantation (B) of the cardiac resynchronization therapy device.