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Europace Advance Access originally published online on August 18, 2006
Europace 2006 8(10):859-862; doi:10.1093/europace/eul090
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

ICD

Native QRS duration predicts the occurrence of arrhythmic events in ICD recipients

Eric C. Stecker, Mehdi Zargarian, Vivek Dogra, Benjamin T. John, Jack Kron, John H. McAnulty and Sumeet S. Chugh*

Heart Rhythm Research Laboratory, Division of Cardiology, UHN-62, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA

Aims Identification of implantable cardioverter/defibrillator (ICD) recipients at higher risk of future therapies may assist in pre-empting future shocks. Native QRS duration is an established predictor of overall mortality, but the role of this parameter as a clinical predictor of arrhythmic events warrants further investigation.

Methods and results In an analysis of a single-centre, 13-year ICD implantation experience (1990–2002), multiple clinical parameters including QRS duration were analysed using a multiple logistic regression model. Of 562 patients followed for at least 1 year, 98 (17%) did not receive ICD therapies (event-free, group A). Comparisons were made with a randomly selected sample of 123 patients who received ICD therapies (arrhythmic events, group B). There were no significant differences in age, gender, frequency of coronary artery disease, and degree of left ventricular dysfunction. However, QRS duration was a significant determinant of arrhythmic events (≥100 vs. <100 ms: adjusted OR 2.75, 95% CI 1.37–5.51; ≥120 vs. <120 ms: adjusted OR 1.77, 95% CI 0.97–3.23). QRS duration was also a predictor of overall mortality in the logistic regression models (≥100 ms: adjusted OR 3.72, 95% CI 1.17–11.9; ≥120 ms: adjusted OR 3.09, 95% CI 1.39–6.85).

Conclusion In this ICD population, consisting largely of secondary prevention ICD recipients, longer QRS duration predicted higher likelihood of arrhythmic events. Extent of QRS prolongation could guide the decision to initiate prophylactic anti-arrhythmic therapy in ICD patients.

Key Words: Risk stratification, Implantable defibrillator, Sudden cardiac death, Heart failure, Prevention

* Corresponding author. Tel: +1 503 494 8750; fax: +1 503 494 8550. E-mail address: chughs{at}ohsu.edu


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