Association between left ventricular lead position and intrinsic QRS morphology with regard to clinical outcome in cardiac resynchronization therapy for heart failure

Autor: Tove Olsson Brandtvig, Sofia Marinko, Maiwand Farouq, Johan Brandt, David Mörtsell, Lingwei Wang, Uzma Chaudhry, Samir Saba, Rasmus Borgquist
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Annals of Noninvasive Electrocardiology, Vol 28, Iss 4, Pp n/a-n/a (2023)
Druh dokumentu: article
ISSN: 1542-474X
1082-720X
DOI: 10.1111/anec.13065
Popis: Abstract Background Left ventricular (LV) lead position may be an important factor for delivering effective cardiac resynchronization therapy (CRT). We therefore aimed to evaluate the effects of LV lead position, stratified by native QRS morphology, regarding the clinical outcome. Methods A total of 1295 CRT‐implanted patients were retrospectively evaluated. LV lead position was classified as lateral, anterior, inferior, or apical, and was determined using the left and right anterior oblique X‐ray views. Kaplan Meier and Cox regression were performed to evaluate the effects on all‐cause mortality and heart failure hospitalization, and the potential interaction between LV lead position and native ECG morphologies. Results A total of 1295 patients were included. Patients were aged 69 ± 7 years, 20% were female, 46% received a CRT‐Pacemaker (vs. CRT‐Defibrillator), mean LVEF was 25% ± 7%, and median follow‐up was 3.3 years [IQR 1.6–5–7 years]. Eight hundred and eighty‐two patients (68%) had a lateral LV lead location, 207 (16%) anterior, 155 (12%) apical, and 51 (4%) inferior. Patients with lateral LV lead position had larger QRS reduction (−13 ± 27 ms vs. −3 ± 24 ms, p
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