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EFFECT OF INTRINSIC QRS MORPHOLOGY ON LONG-TERM RESULT IN RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY
A453 JACC April 1, 2014 Volume 63, Issue 12
Arrhythmias and Clinical EP Effect of Intrinsic QRS Morphology on Long-Term Result in Response to Cardiac Resynchronization Therapy Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Device Therapy in Patients with Heart Failure and Cardiomyopathy Abstract Category: 8. Arrhythmias and Clinical EP: Devices Presentation Number: 1255-105 Authors: Koichi Inoue, Koji Tanaka, Yuko Toyoshima, Nobuaki Tanaka, Takafumi Oka, Yohei Sotomi, Yoichi Nozato, Takaaki Isshiki, T. Kimura, M. Nobuyoshi, Kenji Ando, S. Shizuta, Takeshi Arita, S. Fujii, Katsuomi Iwakura, Kenshi Fujii, Sakurabashi Watanabe Hospital, Osaka, Japan Background: The benefits of cardiac resynchronization therapy (CRT) in non-left bundle branch block (non-LBBB) patients on long-term outcome are still uncertain. Methods: Among patients registered CUBIC study which is a multi-center registry of CRT patients, we investigated 493 de novo patients with echocardiographic data both before and 6 months after implantation. We divided study population into LBBB group (n=258) and non-LBBB group (n=235) based on the intrinsic QRS morphology before implantation. Non-LBBB patients were classified into 3 subgroups: right bundle branch block (RBBB) group; n=57, intra-ventricular conduction delay (IVCD) group; n=65, normal QRS group; n=113. CRT responder was defined as a patient with reduction of left ventricular end systolic volume >/= 15% at 6-month. We followed them for 37 +/- 20 months. The primary and secondary endpoint was death and death or hospitalization. Results: Compared with LBBB group, the CRT responder rate was lower in non-LBBB group (69% vs. 49%, p<0.0001). The mortality of non-LBBB group was higher than that of LBBB group (HR; 95% CI, 1.51; 1.08-2.48, p=0.019). There was no significant difference in mortality between three non-LBBB subgroups (RBBB; 24.6%, IVCD; 26.2%, Normal QRS; 27.4%, p=ns.). Death or hospitalization was also more frequent in non-LBBB group than in LBBB group (1.69; 1.35-2.13, p<0.0001). Conclusions: Non-LBBB QRS morphologies were predictive for worse long-term outcome in de novo CRT patients.
Arrhythmias and Clinical EP Effect of Intrinsic QRS Morphology on Long-Term Result in Response to Cardiac Resynchronization Therapy Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Device Therapy in Patients with Heart Failure and Cardiomyopathy Abstract Category: 8. Arrhythmias and Clinical EP: Devices Presentation Number: 1255-105 Authors: Koichi Inoue, Koji Tanaka, Yuko Toyoshima, Nobuaki Tanaka, Takafumi Oka, Yohei Sotomi, Yoichi Nozato, Takaaki Isshiki, T. Kimura, M. Nobuyoshi, Kenji Ando, S. Shizuta, Takeshi Arita, S. Fujii, Katsuomi Iwakura, Kenshi Fujii, Sakurabashi Watanabe Hospital, Osaka, Japan Background: The benefits of cardiac resynchronization therapy (CRT) in non-left bundle branch block (non-LBBB) patients on long-term outcome are still uncertain. Methods: Among patients registered CUBIC study which is a multi-center registry of CRT patients, we investigated 493 de novo patients with echocardiographic data both before and 6 months after implantation. We divided study population into LBBB group (n=258) and non-LBBB group (n=235) based on the intrinsic QRS morphology before implantation. Non-LBBB patients were classified into 3 subgroups: right bundle branch block (RBBB) group; n=57, intra-ventricular conduction delay (IVCD) group; n=65, normal QRS group; n=113. CRT responder was defined as a patient with reduction of left ventricular end systolic volume >/= 15% at 6-month. We followed them for 37 +/- 20 months. The primary and secondary endpoint was death and death or hospitalization. Results: Compared with LBBB group, the CRT responder rate was lower in non-LBBB group (69% vs. 49%, p<0.0001). The mortality of non-LBBB group was higher than that of LBBB group (HR; 95% CI, 1.51; 1.08-2.48, p=0.019). There was no significant difference in mortality between three non-LBBB subgroups (RBBB; 24.6%, IVCD; 26.2%, Normal QRS; 27.4%, p=ns.). Death or hospitalization was also more frequent in non-LBBB group than in LBBB group (1.69; 1.35-2.13, p<0.0001). Conclusions: Non-LBBB QRS morphologies were predictive for worse long-term outcome in de novo CRT patients.