Heart failure & cardiomyopathies
Electrocardiographic predictors of clinical outcomes in nonischemic cardiomyopathy patients with left bundle branch area pacing cardiac resynchronization therapy
Authors' conclusion
Paced qR morphology and transition during threshold testing predicted greater improvement in LVEF, whereas RWPT lacked predictive value. Loss of terminal R in lead V1 and prolongation of RWPT on follow-up prognosticated nonresponse to LBBAP.
Study context
- Population
- HF patients with nonischemic cardiomyopathy receiving left bundle branch area pacing (LBBAP) CRTof 79 consecutive
- Participants
- 59 patients
- Exposure
- Paced QRS morphology in lead V1: qR vs Qr
- Outcome
- Correlation of paced QRS characteristics on ECG with clinical (echocardiographic) outcomes, incl. LVEF improvement
Methodological detailsconsecutive patients, LBBAP performed using Medtronic 3830 lead
- Consecutive patients
- LBBAP performed using Medtronic 3830 lead
Main finding
As reported in the abstract
LVEF improvement
P = 0.013
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| V6 R-wave peak time (RWPT)qR vs Qr | P = 0.014 |
| Transition during threshold testingqR vs Qr | P = 0.02 |
- V6 R-wave peak time (RWPT): qR 75.7 ± 17.5 ms
- V6 R-wave peak time (RWPT): Qr 85.3 ± 11.3 ms
- Transition during threshold testing: qR 81.5%
- Transition during threshold testing: Qr 53%
RWPT or left ventricular ejection fraction (LVEF) by paced QRS axis (normal, left, right)
- RWPT or LVEF did not differ by paced QRS axis
- P > 0.05
Loss of R' and prolonged RWPT on follow-up, nonresponders vs average responders and superresponders
- Greater incidence of loss of R' in nonresponders
- P = 0.009
- Greater incidence of prolonged RWPT in nonresponders
- P = 0.003
Original publication
Electrocardiographic predictors of clinical outcomes in nonischemic cardiomyopathy patients with left bundle branch area pacing cardiac resynchronization therapy. Heart Rhythm. Published 13 September 2024. doi:10.
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