Advertisement






Click here for more guidelines.
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2006; 48:2243-2250, doi:10.1016/j.jacc.2006.07.067 (Published online 8 November 2006).
© 2006 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.07.067v1
48/11/2243    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bleeker, G. B.
Right arrow Articles by Bax, J. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Bleeker, G. B.
Right arrow Articles by Bax, J. J.

CLINICAL RESEARCH: HEART FAILURE TREATMENT

Cardiac Resynchronization Therapy in Patients With a Narrow QRS Complex

Gabe B. Bleeker, MD*,{dagger}, Eduard R. Holman, MD, PhD*, Paul Steendijk, PhD*, Eric Boersma, PhD{ddagger}, 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
{dagger} Interuniversity Cardiology Institute Netherlands (ICIN), Utrecht, the Netherlands
{ddagger} Department of Epidemiology and Statistics, Erasmus University, Rotterdam, the Netherlands

Manuscript received April 6, 2006; revised manuscript received July 14, 2006, accepted July 27, 2006.

* Reprint requests and correspondence: Dr. Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands (Email: jbax{at}knoware.nl).

OBJECTIVES: The purpose of this study was to evaluate the effects of cardiac resynchronization therapy (CRT) in heart failure patients with narrow QRS complex (<120 ms) and evidence of left ventricular (LV) dyssynchrony on tissue Doppler imaging (TDI).

BACKGROUND: Cardiac resynchronization therapy is beneficial in selected heart failure patients with wide QRS complex (≥120 ms). Patients with narrow QRS complex are currently not eligible for CRT, and the potential effects of CRT are not well studied.

METHODS: Thirty-three consecutive patients with narrow QRS complex and 33 consecutive patients with wide QRS complex (control group) were prospectively included. All patients needed to have LV dyssynchrony ≥65 ms on TDI, New York Heart Association (NYHA) functional class III/IV heart failure, and LV ejection fraction ≤35%.

RESULTS: Baseline characteristics, particularly LV dyssynchrony, were comparable between patients with narrow and wide QRS complex (110 ± 8 ms vs. 175 ± 22 ms; p = NS). No significant relationship was observed between baseline QRS duration and LV dyssynchrony (r = 0.21; p = NS). The improvement in clinical symptoms and LV reverse remodeling was comparable between patients with narrow and wide QRS complex (mean NYHA functional class reduction 0.9 ± 0.6 vs. 1.1 ± 0.6 [p = NS] and mean LV end-systolic volume reduction 39 ± 34 ml vs. 44 ± 46 ml [p = NS]).

CONCLUSIONS: Cardiac resynchronization therapy appears to be beneficial in patients with narrow QRS complex and severe LV dyssynchrony on TDI, with similar improvement in symptoms and comparable LV reverse remodeling to patients with wide QRS complex. The current results need confirmation in larger patient cohorts.

Abbreviations and Acronyms
  CRT = cardiac resynchronization therapy
  EF = ejection fraction
  LV = left ventricular
  NYHA = New York Heart Association
  TDI = tissue Doppler imaging




This article has been cited by other articles:


Home page
Eur J Heart FailHome page
D. J. van Veldhuisen, A. H. Maass, S. G. Priori, P. Stolt, I. C. van Gelder, K. Dickstein, and K. Swedberg
Implementation of device therapy (cardiac resynchronization therapy and implantable cardioverter defibrillator) for patients with heart failure in Europe: changes from 2004 to 2008
Eur J Heart Fail, November 1, 2009; (2009) hfp149v1.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
L. K. Williams, S. Ellery, K. Patel, F. Leyva, R. A. Bleasdale, T. T. Phan, B. Stegemann, V. Paul, P. Steendijk, and M. Frenneaux
Short-Term Hemodynamic Effects of Cardiac Resynchronization Therapy in Patients With Heart Failure, a Narrow QRS Duration, and No Dyssynchrony
Circulation, October 27, 2009; 120(17): 1687 - 1694.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
J. Steffel and D. Hurlimann
Current practice of cardiac resynchronization therapy (CRT) in the real world: insights from the European CRT survey
Eur. Heart J., October 2, 2009; 30(20): 2433 - 2435.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
N. M. Hawkins, M. C. Petrie, M. I. Burgess, and J. J.V. McMurray
Selecting patients for cardiac resynchronization therapy: the fallacy of echocardiographic dyssynchrony.
J. Am. Coll. Cardiol., May 26, 2009; 53(21): 1944 - 1959.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
J. E. Sanderson
Echocardiography for cardiac resynchronization therapy selection: fatally flawed or misjudged?
J. Am. Coll. Cardiol., May 26, 2009; 53(21): 1960 - 1964.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
J C Lekkerkerker, C van Nieuwkoop, S A Trines, J G van der Bom, A Bernards, E T van de Velde, M Bootsma, K Zeppenfeld, J W Jukema, J-W Borleffs, et al.
Risk factors and time delay associated with cardiac device infections: Leiden device registry
Heart, May 1, 2009; 95(9): 715 - 720.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
D. R. Tomlinson, Y. Bashir, T. R. Betts, and K. Rajappan
Accuracy of manual QRS duration assessment: its importance in patient selection for cardiac resynchronization and implantable cardioverter defibrillator therapy
Europace, May 1, 2009; 11(5): 638 - 642.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
G. Rocchi, M. Bertini, M. Biffi, M. Ziacchi, E. Biagini, I. Gallelli, C. Martignani, E. Cervi, M. Ferlito, C. Rapezzi, et al.
Exercise stress echocardiography is superior to rest echocardiography in predicting left ventricular reverse remodelling and functional improvement after cardiac resynchronization therapy
Eur. Heart J., January 1, 2009; 30(1): 89 - 97.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
T Z Naqvi, A M Rafique, C Swerdlow, S Verma, R J Siegel, K Tolstrup, W Kerwin, J Goodman, D Gallik, E Gang, et al.
Predictors of reduction in mitral regurgitation in patients undergoing cardiac resynchronisation treatment
Heart, December 1, 2008; 94(12): 1580 - 1588.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
J. Gorcsan III and M. S. Suffoletto
The role of tissue Doppler and strain imaging in predicting response to CRT
Europace, November 1, 2008; 10(suppl_3): iii80 - iii87.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc ImagingHome page
F. W. Prinzen and A. Auricchio
Is echocardiographic assessment of dyssynchrony useful to select candidates for cardiac resynchronization therapy?: Echocardiography Is Not Useful Before Cardiac Resynchronization Therapy if QRS Duration Is Available
Circ Cardiovasc Imaging, July 1, 2008; 1(1): 70 - 78.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. E. Weyman
The Year in Echocardiography
J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1221 - 1229.
[Full Text] [PDF]


Home page
Eur J Heart FailHome page
A. Auricchio and F. F. Faletra
Mechanical dyssynchrony in CRT patients: Still searching for the Holy Grail!
Eur J Heart Fail, March 1, 2008; 10(3): 217 - 219.
[Full Text] [PDF]


Home page
Eur J Heart FailHome page
S. J. Cazeau, J-C. Daubert, L. Tavazzi, G. Frohlig, and V. Paul
Responders to cardiac resynchronization therapy with narrow or intermediate QRS complexes identified by simple echocardiographic indices of dyssynchrony: The DESIRE study
Eur J Heart Fail, March 1, 2008; 10(3): 273 - 280.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. A. Kass
An epidemic of dyssynchrony: but what does it mean?
J. Am. Coll. Cardiol., January 1, 2008; 51(1): 12 - 17.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. F. Nagueh
Mechanical dyssynchrony in congestive heart failure: diagnostic and therapeutic implications.
J. Am. Coll. Cardiol., January 1, 2008; 51(1): 18 - 22.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
J. van Dijk, P. Knaapen, I.K. Russel, T. Hendriks, C.P. Allaart, C.C. de Cock, and O. Kamp
Mechanical dyssynchrony by 3D echo correlates with acute haemodynamic response to biventricular pacing in heart failure patients
Europace, January 1, 2008; 10(1): 63 - 68.
[Abstract] [Full Text] [PDF]


Home page
NEJMHome page
J. F. Beshai, R. A. Grimm, S. F. Nagueh, J. H. Baker II, S. L. Beau, S. M. Greenberg, L. A. Pires, P. J. Tchou, and the RethinQ Study Investigators
Cardiac-Resynchronization Therapy in Heart Failure with Narrow QRS Complexes
N. Engl. J. Med., December 13, 2007; 357(24): 2461 - 2471.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart J SupplHome page
C. Leclercq, G. B. Bleeker, C. Linde, E. Donal, J. J. Bax, M. J. Schalij, and C. Daubert
Cardiac resynchronization therapy: clinical results and evolution of candidate selection
Eur. Heart J. Suppl., December 1, 2007; 9(suppl_I): I94 - I106.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al.
Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association
Europace, October 1, 2007; 9(10): 959 - 998.
[Full Text] [PDF]


Home page
Eur Heart JHome page
Authors/Task Force Members, P. E. Vardas, A. Auricchio, J.-J. Blanc, J.-C. Daubert, H. Drexler, H. Ector, M. Gasparini, C. Linde, F. B. Morgado, et al.
Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association
Eur. Heart J., September 2, 2007; 28(18): 2256 - 2295.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
O.-A. Breithardt
Cardiac Resynchronization Therapy
J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1899 - 1899.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
G. B. Bleeker, M. J. Schalij, and J. J. Bax
Reply
J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1899 - 1900.
[Full Text] [PDF]


Home page
Journal Watch CardiologyHome page
Does Echo Have a Role in Predicting Benefit from CRT?
Journal Watch Cardiology, January 10, 2007; 2007(110): 3 - 3.
[Full Text]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement