Electrocardiographic Predictors of Response to Cardiac Resynchronization Therapy in Patients With Intraventricular Conduction Delay

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概要

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• 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±18ms, 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±24ms, 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.

• 一般社団法人 日本循環器学会の論文

著者

• Noda Takashi

  Division of Cardiology, National Cardiovascular Center

• Kusano Kengo

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Ishihara Masaharu

  Department Of Cardiology Hiroshima City Hospital

• Takaya Yoichi

  Division of Cardiovascular Medicine, Mitoyo General Hospital

• Ogawa Hisao

  Department Cardiovascular Medicine Kumamoto University:division Of Intensive Care Unit Kumamoto Univ

• Shimizu Wataru

  Division Of Arrhythmia And Electrophysiology Department Of Cardiology National Cerebral And Cardiova

• Aiba Takeshi

  Division Of Arrhythmia And Electrophysiology Department Of Cardiology National Cerebral And Cardiova

• Okamura Hideo

  Division Of Arrhythmia And Electrophysiology Department Of Cardiovascular Medicine National Cerebral

• Yasuda Satoshi

  Department Of Biochemistry Sapporo Medical University School Of Medicine

• Kamakura Shiro

  Division Of Arrhythmia And Electrophysiology Department Of Cardiovascular Medicine National Cerebral

• Yamada Yuko

  Division Of Arrhythmia And Electrophysiology Department Of Cardiovascular Medicine National Cerebral And Cardiovascular Center

• Miyamoto Koji

  Division Of Arrhythmia And Electrophysiology Department Of Cardiovascular Medicine National Cerebral And Cardiovascular Center

• SATOMI Kazuhiro

  Division of Arrhythmias and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Nakajima Ikutaro

  Division of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Miyamoto Koji

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Ogawa Hisao

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kanzaki Hideaki

  Heart Failure, National Cerebral and Cardiovascular Center

• Anzai Toshihisa

  Heart Failure, National Cerebral and Cardiovascular Center

• Nakajima Ikutaro

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Nakajima Ikutaro

  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan

• Aiba Takeshi

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Yamada Yuko

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Kamakura Shiro

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Satomi Kazuhiro

  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan

• Shimizu Wataru

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Okamura Hideo

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Noda Takashi

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Noda Takashi

  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan

• Satomi Kazuhiro

  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Takaya Yoichi

  Divisions of Arrhythmia and Electrophysiology, National Cerebral and Cardiovascular Center

• Noda Takashi

  Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

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