Simplified Selvester Score: a practical electrocardiographic instrument to predict response to CRT

Bani, Rossella; Checchi, Luca; Cartei, Stella; Pieragnoli, Paolo; Ricciardi, Giuseppe; Perini, Alessandro Paoletti; Padeletti, Margherita; Michelotti, Federica; Michelucci, Antonio; Mascioli, Giosuè; Padeletti, Luigi

doi:10.1016/j.jelectrocard.2014.10.014

Cited by 7 publications

(2 citation statements)

References 21 publications

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“…On the other hand, the role of fQRS in predicting response to CRT is not clearly defined. While in the works of Rad et al [ 23 ] and of Rosengarten et al [ 22 ], the presence of fQRS on baseline ECG was associated with nonresponse, our results and those reported by Bani et al [ 19 ] showed no differences between patients with or without fragmentation. This discrepancy may be conceivably ascribed to several factors, such as the number of patients included in the studies (from a minimum of 65 to a maximum of 233), the duration and morphology of baseline QRS (classic LBBB in one study, any kind of ECG in another study, and prolonged QRS duration (≥120 ms) excluding right bundle branch block in Assadian Rad's investigation, only true-LBBB in the present study), and the prevalence of ischemic etiology (from a minimum of 36% in the present study to a maximum of 91%).…”

Section: Discussioncontrasting

confidence: 52%

Myocardial Scar on Surface ECG: Selvester Score, but Not Fragmentation, Predicts Response to CRT

Nesti

Perini

Bani

et al. 2020

Cardiology Research and Practice

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Purpose. Myocardial scar is directly related to the response to CRT after implantation. The extent of myocardial scar can be detected not only by cardiac magnetic resonance but also by two electrocardiographic scores: fragmented QRS (fQRS) and Selvester score (SSc). The aim of our study is to compare the role of baseline SSc and fQRS in predicting response to CRT in a cohort of heart failure patients with true left bundle branch block (LBBB). As a secondary endpoint, we assessed the association of both scores with overall and cardiac mortality, heart failure hospitalizations, ventricular arrhythmias requiring ICD intervention, and major adverse cardiovascular event (MACE). Methods. We evaluated fQRS and SSc of 178 consecutive HF patients with severe systolic dysfunction (LVEF ≤ 35%), NYHA class II-III despite optimal medical treatment, and true-LBBB. Response to CRT was defined as the improvement of LVEF of at least 10% or as the reduction of LVESV of at least 15% at a 6-month follow-up. Each endpoint was related to fQRS and SSc. Results. SSc ≥7 was significantly associated with the absence of echocardiographic response to CRT (OR: 0.327; 95% C.I. 0.155–0.689; p=0.003), while the presence of fQRS at baseline ECG was not (OR: 1.133; 95% C.I. 0.539–2.381; p=0.742). No correlation was found between SSc and overall mortality, cardiac death, ventricular arrhythmias, hospitalizations due to heart failure, or for MACE. Similar results were observed between fQRS and all secondary endpoints. Conclusion. In HF patients with true-LBBB and LVEF ≤35% eligible for CRT, myocardial scar assessed by calculating the SSc on preimplant ECG is an independent predictor of nonresponse after multiple adjustments. Neither SSc nor fQRS is associated with overall and cardiac death, ventricular arrhythmias, or hospitalization for heart failure at a 24-month follow-up.

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Section: Discussioncontrasting

confidence: 52%

Myocardial Scar on Surface ECG: Selvester Score, but Not Fragmentation, Predicts Response to CRT

Nesti

Perini

Bani

et al. 2020

Cardiology Research and Practice

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“…Strain analysis was included in many models later (11,(18)(19)(20). Similarly, to strain analysis, electrophysiologic modalities were also used in risk score development, such as sophisticated ECG analysis (21)(22)(23), vectorcardiography (24), or heart rate histogram analysis (25).…”

Section: Zonimentioning

confidence: 99%

Risk scores in cardiac resynchronization therapy–A review of the literature

Boros

Perge

Merkely

2023

Front. Cardiovasc. Med.

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Cardiac resynchronization therapy (CRT) for selected heart failure (HF) patients improves symptoms and reduces morbidity and mortality; however, the prognosis of HF is still poor. There is an emerging need for tools that might help in optimal patient selection and provide prognostic information for patients and their families. Several risk scores have been created in recent years; although, no literature review is available that would list the possible scores for the clinicians. We identified forty-eight risk scores in CRT and provided the calculation methods and formulas in a ready-to-use format. The reviewed score systems can predict the prognosis of CRT patients; some of them have even provided an online calculation tool. Significant heterogeneity is present between the various risk scores in terms of the variables incorporated and some variables are not yet used in daily clinical practice. The lack of cross-validation of the risk scores limits their routine use and objective selection. As the number of prognostic markers of CRT is overwhelming, further studies might be required to analyze and cross-validate the data.

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