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

Abstract

In this ICD population, consisting largely of secondary prevention 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.

Predictors of mortality amongst recipients of implantable cardioverter defibrillators for secondary prevention of cardiac arrest

“…In keeping with the findings of published ICD trials [17-19], longer QRS duration was associated with decreased survival in our cohort. Prolonged QRS is associated with higher levels of ventricular dyssynchrony, with reduction in the rate of rise of ventricular pressure, and with reduction in diastolic filling times [20,21].…”

Ventricular arrhythmia is predicted by sum absolute QRST integralbut not by QRS width

“…Consistently, several major ICD trials, including MUSTT, MADIT II, and SCD-HeFT, showed the predictive value of QRS duration for all-cause mortality, SCD, and appropriate ICD shocks 6, 8, 9. Retrospective analysis of both primary and secondary prevention ICD patients also revealed that QRS duration ≥ 100 ms predicted appropriate ICD therapies during long-term follow-up 10. A recent prospective study of ICD patients showed that QRS duration > 100 ms predicted appropriate ICD shocks 11.…”

Upper Limit of Vulnerability During Defibrillator Implantations Predicts the Occurrence of Appropriate Shock Therapy for Ventricular Fibrillation

“…Adjusted hazard ratios of the prespecified predictors of ICD therapy such as age, 11 NYHA class, 12 LVEF, 13 QRS duration, 14 BNP concentration, 15 history of atrial fibrillation (AF), 16,17 indications for secondary prevention, 18 use of amiodarone and β-blockers, 19 and ULV >15 J were calculated with Cox proportional hazards regression models. P<0.05 was considered statistically significant.…”