A new simplified electrocardiographic score predicts clinical outcome in patients treated with CRT

Abstract

Composite data from 12-lead ECG during CRT-treatment can be used in a simple score to predict long-term clinical outcome.

Patient‐tailored SyncAV algorithm: A novel strategy to improve synchrony and acute hemodynamic response in heart failure patients treated by cardiac resynchronization therapy

“…During the fast synchronized depolarization process with the SyncAV algorithm, the triple wavefront vectors from intrinsic conduction, RVA pacing, and LV pacing will “cancel out” from the direction of projection used in lead V 1 , which then results in lower summed R+S amplitude in lead V 1 . Moreover, an earlier ID in lead V 1 suggested more successful resynchronization . In the present study, SyncAV algorithm showed a significant advantage over QuickOpt with higher ECG score, indicating better resynchronization and long‐term prognosis.…”

“…Despite lack of long‐term follow‐up, a newly developed ECG score was applied in our study, involving QRSd reduction, summed R+S amplitude in lead V 1 , and ID onset. In survival analysis, increasing total score was associated with a reduced risk for the combined primary endpoint, as well as a reduced risk for heart failure hospitalization . During the fast synchronized depolarization process with the SyncAV algorithm, the triple wavefront vectors from intrinsic conduction, RVA pacing, and LV pacing will “cancel out” from the direction of projection used in lead V 1 , which then results in lower summed R+S amplitude in lead V 1 .…”

“…Thus the total score ranged from 0 to 3 points. Each additional point in the score system represents a gradual improvement in long‐term survival after CRT …”

The VALID‐CRT risk score reliably predicts response and outcome of cardiac resynchronization therapy in a real‐world population

“…The ability of a clinical and echocardiographic score to predict left ventricular remodeling has never been assessed. Very recently, in a cohort of 491 patients, Vegh et al found that a score based on the pre‐ and post‐implantation 12‐lead surface ECG had an independent value in predicting reverse remodeling of the left ventricle and long‐term survival free from HF hospitalization or transplantation . This ECG score is based on QRS duration shortening, intrinsic deflection time and post‐pacing change in R + S amplitude.…”

“…Very recently, in a cohort of 491 patients, Vegh et al found that a score based on the pre-and post-implantation 12-lead surface ECG had an independent value in predicting reverse remodeling of the left ventricle and longterm survival free from HF hospitalization or transplantation. 16 This ECG score is based on QRS duration shortening, intrinsic deflection time and post-pacing change in R + S amplitude. The score is applicable regardless of the intrinsic conduction block pattern on baseline ECG, but seems to be more robust in patients with an a priori left bundle branch block (LBBB).…”