Efficacy of cardiac resynchronized therapy on patients with a fragmented QRS complex

摘要

Background Based on previous studies, a fragmented QRS(f QRS) complex, as a predictive biomarker of myocardial scarring condition, could be used to predict the outcomes of cardiac resynchronized therapy(CRT). However, this conclusion is still debatable. Methods Fifty ischemic or non-ischemic cardiomyopathy patients failure(aged 65 ± 10 yrs, 34 males, 16 females) with refractory heart, diagnosed by the criteria of New York Heart Association received CRT. The ECGs of 18 patients with a f QRS complex(divided by Das)were compared with those of 32 patients without a f QRS complex, who were evaluated by 12-lead ECG before CRT. The patients were followed up for six months, and 12-lead ECG and echocardiography were reviewed. At least 15% reduction in the left ventricular end-systolic volume(LVESV) was defined as responders according to the data obtained for between-group and intra-group analysis. Results Six patients(33.3%) in the f QRS group and 24 patients(75%) in the non-f QRS group responded well. In addition,comparisons of indicators from surface ECG and echocardiography 6 months after CRT showed that the non-f QRS group benefited from CRT significantly more than the f QRS group. Conclusions The f QRS complex has good predictive value for responsiveness to CRT. Non-f QRS complex patients with refractory heart failure may benefit more from CRT, and these patients need to receive this treatment as early as possible.