Combined resynchronization therapy and automatic defibrillator in advanced non-ischaemic heart failure: the importance of QRS width

• Published in: Europace (London, England) Vol. 12; no. 1; pp. 92 - 95
• Main Authors: Cabrera-Bueno, Fernando, Fernández-Pastor, Julia, Molina-Mora, María José, Alzueta, Javier, Peña-Hernández, José Luis, Barrera, Alberto, de Teresa-Galván, Eduardo
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.01.2010
• Subjects: Cardiac Pacing, Artificial - methods; Combined Modality Therapy; Electric Countershock - methods; Electrocardiography - methods; Female; Heart Failure - diagnosis; Heart Failure - etiology; Heart Failure - prevention & control; Humans; Male; Middle Aged; Myocardial Ischemia - complications; Myocardial Ischemia - diagnosis; Myocardial Ischemia - prevention & control; Prognosis; Retrospective Studies; Therapy, Computer-Assisted - methods; Treatment Outcome; Heart failure; Ventricular arrhythmia; Resynchronization; Cardiomyopathy
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/eup348

Aims The combined use of an automatic defibrillator in resynchronization therapy for primary prevention in patients with idiopathic dilated cardiomyopathy is controversial. Methods and results We assessed a series of 46 patients (61 ± 10 years, 64% male) with idiopathic dilated cardiomyopathy undergoing resynchronization therapy combined with a defibrillator in primary prevention and the potential relationship between baseline characteristics and the onset of ventricular arrhythmic events. Of the 46 patients included, eight (17%) presented episodes of ventricular tachycardia/fibrillation during follow-up (19 ± 12 months). There were no baseline differences among these patients, except the proportion of males (57.9 vs. 100%, P = 0.02) and QRS width (162 ± 24 vs. 189 ± 26 ms, P = 0.008), which was the only independent predictor of arrhythmic events (OR 1.42, 95% CI 1.12-1.68; P = 0.03). Conclusion In patients with idiopathic dilated cardiomyopathy undergoing resynchronization therapy combined with a defibrillator, baseline QRS is an independent predictor of arrhythmic events.