Heart Failure; Co-Relation of QRS Duration With Atrial Fibrillation in Patients With Reduced Ejection Fraction

Abstract

ABSTRACT… Introduction: Atrial fibrillation (AF) and wider QRS duration have long been identified to worsen heart failure and LV dysfunction and increase cardiovascular morbidity and mortality. Therefore, it is necessary to identify those patients of heart failure who are at greater risk for cardiovascular morbidity and mortality so that such subjects may be focused for preventive strategies. An association exists between QRS duration and AF with greater incidences of cardiovascular events in patients of heart failure with LV systolic dysfunction. Sampling technique was non-probability, purposive sampling. Result: The study population consisted of male (72.3%) and female (27.7%). Mean LA diameter was 40.3±6.08 mm and mean LV ejection fraction 31.8±6.6 % in the study population. Ischemic heart disease was the most common cause of LV dysfunction (88.3%) followed by non-ischemic cardiomyopathy (8.75%) and non-Ischemic valvular heart disease (3.5%). The frequency of Narrow QRSd (<120 ms) was 62%, Intermediate QRSd (120-150 ms) was 26.5% and Wide QRSd (>150 ms) was 11.5%. The frequency of atrial fibrillation in study population was 15.75%. The frequency of atrial fibrillation was highest in Wide QRSd group (>150 ms) i.e. (60.9%), followed by Intermediate QRSd group (120-150 ms) i.e. (18.9%) and narrow QRSd group (<120 ms) i.e. (6.04%). Patient with atrial fibrillation were more likely to have poor ejection fraction (P<0.0023) and wider QRS duration (P<0.0001). Frequency of atrial fibrillation was highest in Valvular Cardiomyopathy (non-ischemic valvular heart disease) patients (42.8%) as compared to coronary artery disease group (15.3%) and non-ischemic cardimyopathy group (9.4%). Conclusion: In patients of heart failure with reduced ejection fraction (HFrEF), the frequency of atrial fibrillation increases as QRS duration widens. This group of patients must be focused for AF preventive strategies. Key words:Atrial fibrillation (AF), Left ventricular (LV), QRS duration (QRSd). Article Citation: Mir N, Asghar N, Javed S. Heart failure; co-relation of QRS duration with atrial fibrillation in patients with reduced ejection fraction. Professional Med J 2017;24(6):912-918.