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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBORTOLOTTO, Alexandre L.
dc.contributor.authorVERRIER, Richard L.
dc.contributor.authorNEARING, Bruce D.
dc.contributor.authorMARUM, Alexandre A.
dc.contributor.authorSILVA, Bruna Araujo
dc.contributor.authorPEDREIRA, Giovanna C.
dc.contributor.authorSILVA, Fernanda Tessarolo
dc.contributor.authorMEDEIROS, Sofia A.
dc.contributor.authorSROUBEK, Jakub
dc.contributor.authorZIMETBAUM, Peter J.
dc.contributor.authorCHANG, James D.
dc.date.accessioned2020-12-16T14:56:11Z-
dc.date.available2020-12-16T14:56:11Z-
dc.date.issued2020
dc.identifier.citationHEART RHYTHM, v.17, n.11, p.1887-1896, 2020
dc.identifier.issn1547-5271
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/38500-
dc.description.abstractBACKGROUND Reliable quantitative preimplantation predictors of response to cardiac resynchronization therapy (CRT) are needed. OBJECTIVE We tested the utility of preimplantation R-wave and T-wave heterogeneity (RWH and TWH, respectively) compared to standard QRS complex duration in identifying mechanical super-responders to CRT and mortality risk. METHODS We analyzed resting 12-lead electrocardiographic recordings from all 155 patients who received CRT devices between 2006 and 2018 at our institution and met class I and IIA American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines with echocardiograms before and after implantation. Super-responders (n=35, 23%) had >= 20% increase in left ventricular ejection fraction and/or >= 20% decrease in left ventricular end-systolic diameter and were compared with non-super-responders (n=120, 77%), who did not meet these criteria. RWH and TWH were measured using second central moment analysis. RESULTS Among patients with non-left bundle branch block (LBBB), preimplantation RWH was significantly lower in super-responders than in non-super-responders in 3 of 4 lead sets ( P=.001 to P=.038) and TWH in 2 lead sets (both, P=.05), with the corresponding areas under the curve (RWH: 0.810-0.891, P<.001; TWH: 0.759-0.810, P <=.005). No differences were observed in the LBBB group. Preimplantation QRS complex duration also did not differ between super-responders and non-super-responders among patients with ( P=.856) or without ( P=.724) LBBB; the areas under the curve were nonsignificant (both, P=.69). RWH V1-3LILII >= 420 mu V predicted 3-year all-cause mortality in the entire cohort ( P=.037), with a hazard ratio of 7.440 (95% confidence interval 1.015-54.527; P=.048); QRS complex duration >= 150 ms did not predict mortality ( P=.27). CONCLUSION Preimplantation interlead electrocardiographic heterogeneity but not QRS complex duration predicts mechanical super-response to CRT in patients with non-LBBB.eng
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INCeng
dc.relation.ispartofHeart Rhythm
dc.rightsrestrictedAccesseng
dc.subjectCardiac resynchronization therapyeng
dc.subjectHeart failureeng
dc.subjectPreimplantationeng
dc.subjectR-wave heterogeneityeng
dc.subjectSurvivaleng
dc.subjectSuper-responseeng
dc.subjectT-wave heterogeneityeng
dc.subject.othert-wave morphologyeng
dc.subject.otherventricular repolarizationeng
dc.subject.othertransmural dispersioneng
dc.subject.otherqt intervaleng
dc.subject.otherparameterseng
dc.subject.otherdeatheng
dc.subject.otherriskeng
dc.titlePreimplantation interlead ECG heterogeneity is superior to QRS complex duration in predicting mechanical super-response in patients with non-left bundle branch block receiving cardiac resynchronization therapyeng
dc.typearticleeng
dc.rights.holderCopyright ELSEVIER SCIENCE INCeng
dc.identifier.doi10.1016/j.hrthm.2020.05.036
dc.identifier.pmid32497764
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
hcfmusp.author.externalVERRIER, Richard L.:Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; Harvard Med Sch, Boston, MA 02115 USA
hcfmusp.author.externalNEARING, Bruce D.:Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; Harvard Med Sch, Boston, MA 02115 USA
hcfmusp.author.externalSROUBEK, Jakub:Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; Harvard Med Sch, Boston, MA 02115 USA
hcfmusp.author.externalZIMETBAUM, Peter J.:Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; Harvard Med Sch, Boston, MA 02115 USA
hcfmusp.author.externalCHANG, James D.:Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA; Harvard Med Sch, Boston, MA 02115 USA
hcfmusp.description.beginpage1887
hcfmusp.description.endpage1896
hcfmusp.description.issue11
hcfmusp.description.volume17
hcfmusp.origemWOS
hcfmusp.origem.idWOS:000583293800008
hcfmusp.origem.id2-s2.0-85089015463
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUSAeng
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dc.description.indexMEDLINEeng
dc.identifier.eissn1556-3871
hcfmusp.citation.scopus6-
hcfmusp.scopus.lastupdate2022-06-02-
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LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação


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