Echocardiographic and electrocardiographic factors associated with non-response to cardiac resynchronization therapy
Villanueva-Balandrán, Araceli; Aldana-Varela, Oswaldo; Hernández-Mercado, Marco Antonio
ABSTRACT
Introduction: Heart Failure (HF) is a public health problem in Mexico and worldwide. It is one of the most frequent causes of hospitalization and death in the cardiology and internal medicine departments. Cardiac Resynchronization Therapy (CRT) has been an effective treatment for selected patients with HF. However, even in patients with class I recommendations, the rate of non-response is up to 30%, which makes it necessary to identify predictors of non-response.
Objective: to find predictors of non-response to CRT.
Material and methods: the electrocardiographic and echocardiographic features of patients who received CRT at ISSEMyM Medical Center of Toluca (IMCT) were analyzed between June 1st 2003, and June 1st 2019. We looked for an association between these features and the response or non-response to CRT one year after the implantation. A sample of 24 patients with a class I recommendation for CRT were studied; a Multivariate logistic regression analysis was performed to identify predictors of non-response.
Results: 62.5% of the patients with a Left Ventricle End-Diastolic Diameter (LVEDD) ≥ 77 mm were non-responders (p = 0.003); 75% of the patients with fragmented QRS in the electrocardiogram previous to the CRT were non-responders, although this last result with a non-statistically significant p (0.083).
Conclusions: the LVEDD ≥ 77 strongly predicts non-response to CRT. As for the fragmented QRS pattern, even when 75% of patients had it were non-responders, a bigger sample might be required to find statistical significance.
