Electrocardiographic predictors of response to cardiac resynchronization therapy in patients with intraventricular conduction delay

Yoichi Takaya, Takashi Noda, Ikutaro Nakajima, Yuko Yamada, Koji Miyamoto, Hideo Okamura, Kazuhiro Satomi, Takeshi Aiba, Kengo F. Kusano, Hideaki Kanzaki, Toshihisa Anzai, Masaharu Ishihara, Satoshi Yasuda, Hisao Ogawa, Shiro Kamakura, Wataru Shimizu

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Little is known about predictors of response to cardiac resynchronization therapy (CRT) in patients with intraventricular conduction delay (IVCD). The purpose of this study was to investigate the benefits of CRT and significant variables on surface electrocardiogram (ECG) to predict response to CRT in those patients. Methods and Results: Among the cohort of 152 CRT patients, 40 patients with IVCD were evaluated. Sixteen patients (40%) were responders. At baseline, responders had a wider QRS duration (158±18 vs. 144±18 ms, P=0.02) and a higher frequency of left axis deviation (LADEV; 75% vs. 29%, P=0.004) compared with non-responders. After CRT, greater shortening of QRS duration (ΔQRS; 26±24 vs. 7±24 ms, P=0.02), axis shift from LADEV to right axis deviation (RADEV; 69% vs. 13%, P<0.001), and both rightward forces in lead I and anterior forces in V1 (56% vs. 13%, P=0.003) were found more frequently in responders. Multivariable logistic regression analysis showed that LADEV at baseline, or ΔQRS and axis shift from LADEV to RADEV after CRT were independent predictors of response to CRT. Conclusions: Patients with IVCD may not respond to CRT, but LADEV at baseline and reversal of ventricular activation after CRT on surface ECG could be important to predict response to CRT.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalCirculation Journal
Volume78
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Cardiac Resynchronization Therapy
Electrocardiography
Logistic Models
Regression Analysis

Keywords

  • Cardiac resynchronization therapy
  • Electrocardiogram
  • Heart failure
  • Intraventricular conduction delay
  • Responder

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Electrocardiographic predictors of response to cardiac resynchronization therapy in patients with intraventricular conduction delay. / Takaya, Yoichi; Noda, Takashi; Nakajima, Ikutaro; Yamada, Yuko; Miyamoto, Koji; Okamura, Hideo; Satomi, Kazuhiro; Aiba, Takeshi; Kusano, Kengo F.; Kanzaki, Hideaki; Anzai, Toshihisa; Ishihara, Masaharu; Yasuda, Satoshi; Ogawa, Hisao; Kamakura, Shiro; Shimizu, Wataru.

In: Circulation Journal, Vol. 78, No. 1, 2014, p. 71-77.

Research output: Contribution to journalArticle

Takaya, Y, Noda, T, Nakajima, I, Yamada, Y, Miyamoto, K, Okamura, H, Satomi, K, Aiba, T, Kusano, KF, Kanzaki, H, Anzai, T, Ishihara, M, Yasuda, S, Ogawa, H, Kamakura, S & Shimizu, W 2014, 'Electrocardiographic predictors of response to cardiac resynchronization therapy in patients with intraventricular conduction delay', Circulation Journal, vol. 78, no. 1, pp. 71-77. https://doi.org/10.1253/circj.CJ-12-1569
Takaya, Yoichi ; Noda, Takashi ; Nakajima, Ikutaro ; Yamada, Yuko ; Miyamoto, Koji ; Okamura, Hideo ; Satomi, Kazuhiro ; Aiba, Takeshi ; Kusano, Kengo F. ; Kanzaki, Hideaki ; Anzai, Toshihisa ; Ishihara, Masaharu ; Yasuda, Satoshi ; Ogawa, Hisao ; Kamakura, Shiro ; Shimizu, Wataru. / Electrocardiographic predictors of response to cardiac resynchronization therapy in patients with intraventricular conduction delay. In: Circulation Journal. 2014 ; Vol. 78, No. 1. pp. 71-77.
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abstract = "Background: Little is known about predictors of response to cardiac resynchronization therapy (CRT) in patients with intraventricular conduction delay (IVCD). The purpose of this study was to investigate the benefits of CRT and significant variables on surface electrocardiogram (ECG) to predict response to CRT in those patients. Methods and Results: Among the cohort of 152 CRT patients, 40 patients with IVCD were evaluated. Sixteen patients (40{\%}) were responders. At baseline, responders had a wider QRS duration (158±18 vs. 144±18 ms, P=0.02) and a higher frequency of left axis deviation (LADEV; 75{\%} vs. 29{\%}, P=0.004) compared with non-responders. After CRT, greater shortening of QRS duration (ΔQRS; 26±24 vs. 7±24 ms, P=0.02), axis shift from LADEV to right axis deviation (RADEV; 69{\%} vs. 13{\%}, P<0.001), and both rightward forces in lead I and anterior forces in V1 (56{\%} vs. 13{\%}, P=0.003) were found more frequently in responders. Multivariable logistic regression analysis showed that LADEV at baseline, or ΔQRS and axis shift from LADEV to RADEV after CRT were independent predictors of response to CRT. Conclusions: Patients with IVCD may not respond to CRT, but LADEV at baseline and reversal of ventricular activation after CRT on surface ECG could be important to predict response to CRT.",
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author = "Yoichi Takaya and Takashi Noda and Ikutaro Nakajima and Yuko Yamada and Koji Miyamoto and Hideo Okamura and Kazuhiro Satomi and Takeshi Aiba and Kusano, {Kengo F.} and Hideaki Kanzaki and Toshihisa Anzai and Masaharu Ishihara and Satoshi Yasuda and Hisao Ogawa and Shiro Kamakura and Wataru Shimizu",
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T1 - Electrocardiographic predictors of response to cardiac resynchronization therapy in patients with intraventricular conduction delay

AU - Takaya, Yoichi

AU - Noda, Takashi

AU - Nakajima, Ikutaro

AU - Yamada, Yuko

AU - Miyamoto, Koji

AU - Okamura, Hideo

AU - Satomi, Kazuhiro

AU - Aiba, Takeshi

AU - Kusano, Kengo F.

AU - Kanzaki, Hideaki

AU - Anzai, Toshihisa

AU - Ishihara, Masaharu

AU - Yasuda, Satoshi

AU - Ogawa, Hisao

AU - Kamakura, Shiro

AU - Shimizu, Wataru

PY - 2014

Y1 - 2014

N2 - Background: Little is known about predictors of response to cardiac resynchronization therapy (CRT) in patients with intraventricular conduction delay (IVCD). The purpose of this study was to investigate the benefits of CRT and significant variables on surface electrocardiogram (ECG) to predict response to CRT in those patients. Methods and Results: Among the cohort of 152 CRT patients, 40 patients with IVCD were evaluated. Sixteen patients (40%) were responders. At baseline, responders had a wider QRS duration (158±18 vs. 144±18 ms, P=0.02) and a higher frequency of left axis deviation (LADEV; 75% vs. 29%, P=0.004) compared with non-responders. After CRT, greater shortening of QRS duration (ΔQRS; 26±24 vs. 7±24 ms, P=0.02), axis shift from LADEV to right axis deviation (RADEV; 69% vs. 13%, P<0.001), and both rightward forces in lead I and anterior forces in V1 (56% vs. 13%, P=0.003) were found more frequently in responders. Multivariable logistic regression analysis showed that LADEV at baseline, or ΔQRS and axis shift from LADEV to RADEV after CRT were independent predictors of response to CRT. Conclusions: Patients with IVCD may not respond to CRT, but LADEV at baseline and reversal of ventricular activation after CRT on surface ECG could be important to predict response to CRT.

AB - Background: Little is known about predictors of response to cardiac resynchronization therapy (CRT) in patients with intraventricular conduction delay (IVCD). The purpose of this study was to investigate the benefits of CRT and significant variables on surface electrocardiogram (ECG) to predict response to CRT in those patients. Methods and Results: Among the cohort of 152 CRT patients, 40 patients with IVCD were evaluated. Sixteen patients (40%) were responders. At baseline, responders had a wider QRS duration (158±18 vs. 144±18 ms, P=0.02) and a higher frequency of left axis deviation (LADEV; 75% vs. 29%, P=0.004) compared with non-responders. After CRT, greater shortening of QRS duration (ΔQRS; 26±24 vs. 7±24 ms, P=0.02), axis shift from LADEV to right axis deviation (RADEV; 69% vs. 13%, P<0.001), and both rightward forces in lead I and anterior forces in V1 (56% vs. 13%, P=0.003) were found more frequently in responders. Multivariable logistic regression analysis showed that LADEV at baseline, or ΔQRS and axis shift from LADEV to RADEV after CRT were independent predictors of response to CRT. Conclusions: Patients with IVCD may not respond to CRT, but LADEV at baseline and reversal of ventricular activation after CRT on surface ECG could be important to predict response to CRT.

KW - Cardiac resynchronization therapy

KW - Electrocardiogram

KW - Heart failure

KW - Intraventricular conduction delay

KW - Responder

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