ArticleJournal of cardiovascular electrophysiology2021
Reduction in the QRS area after cardiac resynchronization therapy is associated with survival and echocardiographic response.
Article in Journal of cardiovascular electrophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
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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.
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Who cites it
25 citing papers in PubMed, 36 citations in OpenAlex.
- Left Bundle Branch Pacing Versus Biventricular Pacing for Acute Cardiac Resynchronization in Patients With Heart Failure.Circulation. Arrhythmia and electrophysiology · 2022Trial
- Electrocardiographic Correlates of Myocardial Remodeling After Cardiac Resynchronization Therapy.Pacing and clinical electrophysiology : PACE · 2026Article
- QRS Area Before and After Upgrading to Cardiac Resynchronization Therapy Is Not Sufficient to Predict Outcome.Journal of cardiovascular development and disease · 2026Article
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- Larger spatial ventricular gradient magnitude is associated with higher rates of response to cardiac resynchronization therapy.Heart rhythm O2 · 2025Article
- Mid- to long-term mechanical performance of left bundle branch area pacing: a comprehensive echocardiographic comparison of capture modalities.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Vectorcardiography in CRT: What We Know and What There Is to Learn.Journal of cardiovascular development and disease · 2025Review
- Assessment of ventricular electrical heterogeneity in left bundle branch pacing and left ventricular septal pacing by using various electrophysiological methods.Journal of cardiovascular electrophysiology · 2024Article
- Multicenter Hemodynamic Assessment of the LOT-CRT Strategy: When Does Combining Left Bundle Branch Pacing and Coronary Venous Pacing Enhance Resynchronization?: Primary Results of the CSPOT Study.Circulation. Arrhythmia and electrophysiology · 2024Article
- 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
- Implantable Cardiac Devices in Patients with Brady- and Tachy-Arrhythmias: An Update of the Literature.Reviews in cardiovascular medicine · 2024Review
- Quest for the ideal assessment of electrical ventricular dyssynchrony in cardiac resynchronization therapy.Journal of molecular and cellular cardiology plus · 2024Review
- Association of vectorcardiographic T-wave area with clinical and echocardiographic outcomes in cardiac resynchronization therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Comparison of novel ventricular pacing strategies using an electro-mechanical simulation platform.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Electrocardiogram-based deep learning improves outcome prediction following cardiac resynchronization therapy.European heart journal · 2023Article
- Does mechanical dyssynchrony in addition to QRS area ensure sustained response to cardiac resynchronization therapy?European heart journal. Cardiovascular Imaging · 2022Article
- A single-centre prospective evaluation of left bundle branch area pacemaker implantation characteristics.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2022Article
- Ventricular Dyssynchrony and Pacing-induced Cardiomyopathy in Patients with Pacemakers, the Utility of Ultra-high-frequency ECG and Other Dyssynchrony Assessment Tools.Arrhythmia & electrophysiology review · 2022Review
- Vectorcardiographic QRS area as a predictor of response to cardiac resynchronization therapy.Journal of geriatric cardiology : JGC · 2022Article
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Corrections and comments
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRecent studies have shown that the baseline QRS area is associated with the clinical response after cardiac resynchronization therapy (CRT). In this study, we investigated the association of QRS area reduction (∆QRS area) after CRT with the outcome. We hypothesize that a larger ∆QRS area is associated with a better survival and echocardiographic response. METHODS AND
resultsElectrocardiograms (ECG) obtained before and 2-12 months after CRT from 1299 patients in a multi-center CRT-registry were analyzed. The QRS area was calculated from vectorcardiograms that were synthesized from 12-lead ECGs. The primary endpoint was a combination of all-cause mortality, heart transplantation, and left ventricular (LV) assist device implantation. The secondary endpoint was the echocardiographic response, defined as LV end-systolic volume reduction ≥ of 15%. Patients with ∆QRS area above the optimal cut-off value (62 µVs) had a lower risk of reaching the primary endpoint (hazard ratio: 0.43; confidence interval [CI] 0.33-0.56, p < .001), and a higher chance of echocardiographic response (odds ratio [OR] 3.3;CI 2.4-4.6, p < .0001). In multivariable analysis, ∆QRS area was independently associated with both endpoints. In patients with baseline QRS area ≥109 µVs, survival, and echocardiographic response were better when the ∆QRS area was ≥62 µVs (p < .0001). Logistic regression showed that in patients with baseline QRS area ≥109 µVs, ∆QRS area was the only significant predictor of survival (OR: 0.981; CI: 0.967-0.994, p = .006).
conclusion∆QRS area is an independent determinant of CRT response, especially in patients with a large baseline QRS area. Failure to achieve a large QRS area reduction with CRT is associated with a poor clinical outcome.
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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.