Europace Advance Access published online on November 6, 2009
Europace, doi:10.1093/europace/eup348
CLINICAL RESEARCH
Combined resynchronization therapy and automatic defibrillator in advanced non-ischaemic heart failure: the importance of QRS width
1 Cardiology Service, Hospital Clínico Universitario Virgen de la Victoria, Campus Teatinos s/n 29010, Málaga, Spain; 2 C/ Madame Bovary 21, casa 14, CP, 29620. Málaga, Spain
Aims: The combined use of an automatic defibrillator in resynchronization therapy for primary prevention in patients with idiopathic dilated cardiomyopathy is controversial.
Methods and results: We assessed a series of 46 patients (61 ± 10 years, 64% male) with idiopathic dilated cardiomyopathy undergoing resynchronization therapy combined with a defibrillator in primary prevention and the potential relationship between baseline characteristics and the onset of ventricular arrhythmic events. Of the 46 patients included, eight (17%) presented episodes of ventricular tachycardia/fibrillation during follow-up (19 ± 12 months). There were no baseline differences among these patients, except the proportion of males (57.9 vs. 100%, P = 0.02) and QRS width (162 ± 24 vs. 189 ± 26 ms, P = 0.008), which was the only independent predictor of arrhythmic events (OR 1.42, 95% CI 1.12–1.68; P = 0.03).
Conclusion: In patients with idiopathic dilated cardiomyopathy undergoing resynchronization therapy combined with a defibrillator, baseline QRS is an independent predictor of arrhythmic events.
Key Words: Resynchronization, Ventricular arrhythmia, Cardiomyopathy, Heart failure
* Corresponding author. Tel: +34 95 103 2441/6591 9130, Fax: +34 95 103 2441, Email: fjcabrera{at}secardiologia.es
Manuscript submitted 1 October 2009. Accepted after revision 9 October 2009.