Meta-Analysis of the Usefulness of Change in QRS Width to Predict Response to Cardiac Resynchronization Therapy.
Title | Meta-Analysis of the Usefulness of Change in QRS Width to Predict Response to Cardiac Resynchronization Therapy. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Korantzopoulos, P., Zhang Z., Li G., Fragakis N., & Liu T. |
Journal | Am J Cardiol |
Volume | 118 |
Issue | 9 |
Pagination | 1368-1373 |
Date Published | 2016 Nov 01 |
ISSN | 1879-1913 |
Keywords | Cardiac Resynchronization Therapy, Echocardiography, Heart Conduction System, Humans, Predictive Value of Tests, Ventricular Dysfunction, Left |
Abstract | The existing data regarding the role of QRS duration (QRSd) change on cardiac resynchronization therapy (CRT) response show some inconsistent results. We conducted a meta-analysis of data obtained from observational studies to examine the impact of QRS change after CRT device implantation on the clinical and/or echocardiographic response. We searched the PubMed and EMBASE databases for relevant studies published before January 2016. Twenty-seven studies were retrieved for detailed evaluation of which 12 studies with a total population of 1,545 patients met our eligibility criteria. The analysis demonstrated that QRSd narrowing was a positive predictor of response to CRT (mean difference [MD] = -19.24 ms, 95% CI = -24.00 to -14.48 ms, p <0.00001). This effect was consistent in the studies using clinical criteria (MD = -19.91 ms, 95% CI = -27.20 to -12.62 ms, p <0.00001) and in those that used echocardiographic criteria (MD = -19.51 ms, 95% CI = -25.78 to -13.25 ms, p <0.00001). The heterogeneity test showed moderate differences among the individual studies (I = 42%). Subgroup analysis showed that QRSd change was more pronounced in studies having a follow-up ≤6 months. We did not find significant differences in studies measuring postimplantation QRSd after a certain follow-up period compared with studies measuring QRSd immediately after CRT device implantation. Further studies should clarify the exact timing of QRSd assessments during follow-up. In conclusion, QRSd shortening after CRT device implantation is associated with a favorable clinical and echocardiographic response. |
DOI | 10.1016/j.amjcard.2016.07.070 |
Alternate Journal | Am. J. Cardiol. |
PubMed ID | 27634027 |