ArticleHeart rhythm2019
Vectorcardiographic QRS area is associated with long-term outcome after cardiac resynchronization therapy.
Article in Heart rhythm, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.Heart rhythm · 2023Guideline
- QRS Area Before and After Upgrading to Cardiac Resynchronization Therapy Is Not Sufficient to Predict Outcome.Journal of cardiovascular development and disease · 2026Article
- Vectorcardiography in CRT: What We Know and What There Is to Learn.Journal of cardiovascular development and disease · 2025Review
- Prevalence and prognostic value of ventricular conduction delay in heart failure with preserved ejection fraction.International journal of cardiology. Heart & vasculature · 2025Article
- Article
- Monitoring of myocardial injury by serial measurements of QRS area and T area: The MaastrICCht cohort.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Article
- Different methods of 3D QRS area calculation from vectorcardiographic X, Y, and Z Leads.Pacing and clinical electrophysiology : PACE · 2024Article
- The association between coronary artery calcification and vectorcardiography in mechanically ventilated COVID-19 patients: the Maastricht Intensive Care COVID cohort.Intensive care medicine experimental · 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
- Useful Electrocardiographic Signs to Support the Prediction of Favorable Response to Cardiac Resynchronization Therapy.Journal of cardiovascular development and disease · 2023Review
- 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.Journal of arrhythmia · 2023Article
- Article
- Combination of personalized computational modeling and machine learning for optimization of left ventricular pacing site in cardiac resynchronization therapy.Frontiers in physiology · 2023Article
- Vectorcardiography-derived index allows a robust quantification of ventricular electrical synchrony.Scientific reports · 2022Article
- Electrical management of heart failure: from pathophysiology to treatment.European heart journal · 2022Review
- Vectorcardiographic QRS area as a predictor of response to cardiac resynchronization therapy.Journal of geriatric cardiology : JGC · 2022Article
- Cardiac resynchronization considerations in left bundle branch block.Frontiers in physiology · 2022Review
- Recruitment of the cardiac conduction system for optimal resynchronization therapy in failing heart.Frontiers in physiology · 2022Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
backgroundRecent studies have suggested that vectorcardiographic measures predict left ventricular (LV) reverse remodeling and clinical outcome in patients receiving cardiac resynchronization therapy (CRT).
objectivesThe objectives of this study were to compare predictive abilities of different vectorcardiographic measures (QRS area and sum absolute QRS-T integral) and transformation methods (Kors and inverse Dower) and to assess the independent association between the best predictor and outcomes in CRT recipients.
methodsThis retrospective study included CRT recipients with a digital baseline electrocardiogram, QRS duration ≥120 ms, and ejection fraction ≤35%. The end point was a composite of heart transplantation, LV assist device implantation, or all-cause death. Analyses were performed for the overall cohort and for a prespecified subgroup of patients with left bundle branch block (LBBB).
resultsOf 705 included patients with a mean age of 66.6 ± 11.5 years, 492 (70%) were men, 374 (53%) had ischemic heart disease, and 465 (66%) had LBBB. QRS area from vectorcardiograms derived via the Kors transformation demonstrated the best predictive value. In multivariable Cox regression, patients with a smaller QRS area (≤ 95 μVs) had an increased hazard in the overall cohort (adjusted hazard ratio 1.65; 95% CI 1.25-2.18 P < .001) and in the LBBB subgroup (adjusted hazard ratio 1.95; 95% CI 1.38-2.76 P < .001). QRS area was associated with outcome in patients with QRS duration <150 ms (unadjusted hazard ratio 3.85; 95% CI 2.02-7.37 P < .001) and in patients with QRS duration ≥150 ms (unadjusted hazard ratio 1.76; 95% CI 1.32-2.34 P < .001).
conclusionVectorcardiographic QRS area is associated with survival free from heart transplantation and LV assist device implantation in CRT recipients.
Indexed as
Identifiers
What OpenQuestion holds
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.