T‐Wave Area Predicts Response to Cardiac Resynchronization Therapy in Patients with Left Bundle Branch Block

Engels, Elien B.; Végh, Edit; Deursen, Caroline J.M. van; Vernooy, Kevin; Singh, Jagmeet P.; Prinzen, Frits W.

doi:10.1111/jce.12549

Cited by 40 publications

(35 citation statements)

References 28 publications

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“…Similarly, the OR of T-wave area to predict CRT response is 1.172 per 10 μV-s [16]. Our observed parameter value alterations may lead to a change in prediction of CRT response based on QRS area in patients 2 and 5 and based on T-wave area in patients 3 and 4.…”

Section: Discussionmentioning

confidence: 59%

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An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects

Nguyên¹,

Potse²,

Regoli³

et al. 2015

Journal of Electrocardiology

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Aim: The aim of this study was to investigate the influence of geometrical factors on the ECG morphology and vectorcardiogram (VCG) parameters. Methods: Patient-tailored models based on five heart-failure patients with intraventricular conduction defects (IVCDs) were created. The heart was shifted up to 6 cm to the left, right, up, and down and rotated ±30°around the anteroposterior axis. Precordial electrodes were shifted 3 cm down.Results: Geometry modifications strongly altered ECG notching/slurring and intrinsicoid deflection time. Maximum VCG parameter changes were small for QRS duration (− 6% to + 10%) and QRS-T angle (− 6% to + 3%), but considerable for QRS amplitude (− 36% to + 59%), QRS area (− 37% to + 42%), T-wave amplitude (− 41% to + 36%), and T-wave area (− 42% to + 33%). Conclusion:The position of the heart with respect to the electrodes is an important factor determining notching/slurring and voltage-dependent parameters and therefore must be considered for accurate diagnosis of IVCDs.

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Section: Discussionmentioning

confidence: 59%

“…The QRS area was calculated from the time-voltage area of the QRS complex in the X, Y, and Z leads (A QRS,x , A QRS,y , A QRS,z ) of the VCG [15,16]:…”

Section: Quantitative Evaluationmentioning

confidence: 99%

An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects

Nguyên¹,

Potse²,

Regoli³

et al. 2015

Journal of Electrocardiology

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“…However, the basis of these discordant T-waves is not clear and neither whether such discordant T-waves should be regarded as adverse or whether they are simply a consequence of the extremely long depolarization time. The interest for the T-wave in patients with wide QRS complex is also growing, owing to recent publications reporting that the size of the T-wave is a good predictor of CRT response [7,8] and that a reduction in LV action potential duration following CRT is associated with a good echocardiographic response to CRT [9]. To the best of our knowledge, no studies have been investigating the cause of the discordant T-waves in patients with wide QRS complex.…”

Section: Introductionmentioning

confidence: 99%

The relation between local repolarization and T-wave morphology in heart failure patients

Maffessanti

Wanten

Potse

et al. 2017

International Journal of Cardiology

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“…An increase of ≥ 5% in LVEF at the six-month follow-up was defined as a positive echocardiographic response [15,16]. Clinical response was defined as improvement ≥ 1 NYHA class and without HF hospitalisation.…”

Section: Definition Of Crt Responsementioning

confidence: 99%

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

Balcı

Şen

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: In many cardiovascular diseases (CVD), white blood cell counts with differentials are used to predict adverse events. Both platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are studied in various CVDs. Aim:The role of inflammatory condition assessed using routine laboratory tests in cardiac resynchronisation therapy (CRT) response has not been investigated thoroughly. Therefore, we aimed to assess the association of NLR, PLR, and relative lymphocyte count (L%) with response to CRT. Methods:A total of 157 patients (76.4% male; mean age 58.7 ± 11.8 years) who underwent CRT implantation at our tertiary referral hospital were retrospectively analysed.Results: Among included patients, a total of 50 (31.8%) patients were defined as "non-responders". Median NLR and PLR were significantly higher in the non-responder group (p < 0.001), and median L% was significantly lower in the non-responder group (p < 0.001). Also, median NLR was significantly higher in patients with New York heart Association (NYHA) class II-III when compared to patients with NYHA class I after six months of CRT implantation (p < 0.001, p = 0.004, respectively). Correlation analysis demonstrated a positive correlation between paced QRS duration and NLR (p = 0.031) and a negative correlation between paced QRS duration and L% (p = 0.002). In addition, both NLR and L% showed significant correlations with post-procedural NYHA functional classes (p < 0.001; p = 0.008, respectively). Patients with PLR > 173.09 had a 2.9-fold and NLR > 3.45 had a 12.2-fold increased risk of CRT nonresponse, respectively. Conclusions:In the current study non-responders to CRT had higher NLR and PLR and lower L%, which may support the deleterious effects of baseline inflammatory condition in advanced heart failure.

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T‐Wave Area Predicts Response to Cardiac Resynchronization Therapy in Patients with Left Bundle Branch Block

Abstract: In patients with LBBB morphology of the QRS complex, a larger baseline T-wave area is an important independent predictor of LVEF increase following CRT.

Cited by 40 publications

References 28 publications

An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects

An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects

The relation between local repolarization and T-wave morphology in heart failure patients

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

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