Native QRS duration predicts the occurrence of arrhythmic events in ICD recipients

Eric C. Stecker, Mehdi Zargarian, Vivek Dogra, Benjamin T. John, Jack Kron, John H. McAnulty, Sumeet S. Chugh

    Research output: Contribution to journalArticlepeer-review

    17 Scopus citations

    Abstract

    Aims: Identification of implantable cardioverter/defibrillator (ICD) recipients at higher risk of future therapies may assist in pre-empting future shocks. Native QRS duration is an established predictor of overall mortality, but the role of this parameter as a clinical predictor of arrhythmic events warrants further investigation. Methods and results: In an analysis of a single-centre, 13-year ICD implantation experience (1990-2002), multiple clinical parameters including QRS duration were analysed using a multiple logistic regression model. Of 562 patients followed for at least 1 year, 98 (17%) did not receive ICD therapies (event-free, group A). Comparisons were made with a randomly selected sample of 123 patients who received ICD therapies (arrhythmic events, group B). There were no significant differences in age, gender, frequency of coronary artery disease, and degree of left ventricular dysfunction. However, QRS duration was a significant determinant of arrhythmic events (≥100 vs. <100 ms: adjusted OR 2.75, 95% CI 1.37-5.51; ≥120 vs. <120 ms: adjusted OR 1.77, 95% CI 0.97-3.23). QRS duration was also a predictor of overall mortality in the logistic regression models (≥100 ms: adjusted OR 3.72, 95% CI 1.17-11.9; ≥120 ms: adjusted OR 3.09, 95% CI 1.39-6.85). Conclusion: In this ICD population, consisting largely of secondary pre vention ICD recipients, longer QRS duration predicted higher likelihood of arrhythmic events. Extent of QRS prolongation could guide the decision to initiate prophylactic anti-arrhythmic therapy in ICD patients.

    Original languageEnglish (US)
    Pages (from-to)859-862
    Number of pages4
    JournalEuropace
    Volume8
    Issue number10
    DOIs
    StatePublished - Oct 2006

    Keywords

    • Heart failure
    • Implantable defibrillator
    • Prevention
    • Risk stratification
    • Sudden cardiac death

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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