Trial reportHeart rhythm2015
Novel measure of electrical dyssynchrony predicts response in cardiac resynchronization therapy: Results from the SMART-AV Trial.
Trial report in Heart rhythm, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 45 citations in OpenAlex.
- Using Machine-Learning for Prediction of the Response to Cardiac Resynchronization Therapy: The SMART-AV Study.JACC. Clinical electrophysiology · 2021Trial
- Response to cardiac resynchronisation therapy in men and women: a secondary analysis of the SMART-AV randomised controlled trial.BMJ open · 2021Trial
- Larger spatial ventricular gradient magnitude is associated with higher rates of response to cardiac resynchronization therapy.Heart rhythm O2 · 2025Article
- Vectorcardiography in CRT: What We Know and What There Is to Learn.Journal of cardiovascular development and disease · 2025Review
- Optimizing outcomes from cardiac resynchronization therapy: what do recent data and insights say?Expert review of cardiovascular therapy · 2024Review
- Electrical Heterogeneity in Hispanic Background Subpopulations: The HCHS/SOL.JACC. Advances · 2024Article
- Quest for the ideal assessment of electrical ventricular dyssynchrony in cardiac resynchronization therapy.Journal of molecular and cellular cardiology plus · 2024Review
- Ultra-High-Frequency ECG in Cardiac Pacing and Cardiac Resynchronization Therapy: From Technical Concept to Clinical Application.Journal of cardiovascular development and disease · 2024Review
- Right ventricular lead sensing latency in pacemaker therapy.Journal of arrhythmia · 2022Article
- Vectorcardiography-derived index allows a robust quantification of ventricular electrical synchrony.Scientific reports · 2022Article
- Digitizing ECG image: A new method and open-source software code.Computer methods and programs in biomedicine · 2022Article
- Adaptive Cardiac Resynchronization Therapy Effect on Electrical Dyssynchrony (aCRT-ELSYNC): A randomized controlled trial.Heart rhythm O2 · 2021Article
- Characteristics of Cardiac Memory in Patients with Implanted Cardioverter-defibrillators: The Cardiac Memory with Implantable Cardioverter-defibrillator (CAMI) Study.The Journal of innovations in cardiac rhythm management · 2021Article
- Machine Learning of 12-Lead QRS Waveforms to Identify Cardiac Resynchronization Therapy Patients With Differential Outcomes.Circulation. Arrhythmia and electrophysiology · 2020Article
- R-Wave Singularity: A New Morphological Approach to the Analysis of Cardiac Electrical Dyssynchrony.Frontiers in physiology · 2020Article
- Vectorcardiographic QRS area is associated with long-term outcome after cardiac resynchronization therapy.Heart rhythm · 2019Article
- Global Electrical Heterogeneity: Mechanisms and Clinical Significance.Computing in cardiology · 2018Article
- Genome-Wide Associations of Global Electrical Heterogeneity ECG Phenotype: The ARIC (Atherosclerosis Risk in Communities) Study and CHS (Cardiovascular Health Study).Journal of the American Heart Association · 2018Article
- Early prediction of cardiac resynchronization therapy response by non-invasive electrocardiogram markers.Medical & biological engineering & computing · 2018Article
- Dynamic Changes in High-Sensitivity Cardiac Troponin I Are Associated with Dynamic Changes in Sum Absolute QRST Integral on Surface Electrocardiogram in Acute Decompensated Heart Failure.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2017Observational
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundCardiac resynchronization therapy (CRT) reduces mortality and morbidity in selected heart failure patients. However, not all patients respond to CRT.
objectiveWe hypothesized that a novel measure of electrical dyssynchrony, sum absolute QRST integral (SAI QRST), predicts CRT response independent of QRS duration and morphology.
methodsWe retrospectively analyzed baseline 12-lead electrocardiograms of SmartDelay Determined AV Optimization: A comparison to other AV delay methods used in cardiac resynchronization therapy (SMART-AV) trial study participants (N = 234; mean age 67 years; 163 (70%) men; 140 (60%) ischemic cardiomyopathy; mean left ventricular ejection fraction 25%; mean QRS duration 152 ms; 179 (77%) had left bundle branch block). Baseline pre-implant electrocardiograms were digitized, transformed into orthogonal XYZ, and analyzed automatically by customized MATLAB software. SAI QRST was measured as an averaged arithmetic sum of absolute areas under the QRST curve. Patients were followed prospectively 6 months after CRT-defibrillator implantation. Patients with a decrease in left ventricular end-systolic volume ≥15 mL after 6 months of CRT were considered responders. The logistic regression model was adjusted for age, sex, bundle branch block morphology, left ventricular ejection fraction, cardiomyopathy type, and QRS duration.
resultsPatients with the high mean SAI QRST (third tertile) had 2.5 times greater odds of response than those with the low mean SAI QRST (first tertile: odds ratio [OR] 2.5; 95% confidence interval [CI] 1.3-5.0; P = .010) and 1.9 times greater than the lower 2 tertiles combined (OR 1.9; 95% CI 1.1-3.5; P = .03). Adjustment for renal function (OR 2.33; 95% CI 1.32-4.11; P = .003) and left ventricular lead position in right anterior oblique and left anterior oblique views (OR 1.7; 95% CI 0.9-3.2; P = .087) did not attenuate association of SAI QRST with outcome.
conclusionHigh SAI QRST independently predicts CRT response in the SMART-AV study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.