Native QRS complex duration predicts paced QRS width in patients with normal left ventricular function and right ventricular pacing for atrioventricular block

Abstract Introduction Prolonged paced QRS duration is a predictor of development of heart failure during chronic right ventricular pacing. One determinant of paced QRS width might be His-Purkinje system dysfunction, manifested in wide native (escape or conducted beat) QRS complexes in patients with...

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Bibliographic Details
Published in:Journal of electrocardiology 2007-07, Vol.40 (4), p.360-364
Main Authors: Pap, Róbert, MD, Fürge, Péter, MD, Bencsik, Gábor, MD, Makai, Attila, MD, Sághy, László, MD, Forster, Tamás, MD, PhD, DSc
Format: Article
Language:English
Subjects:
Aged
Atrioventricular block
Cardiac Pacing, Artificial - methods
Cardiovascular
Diagnosis, Computer-Assisted - methods
Electrocardiography - methods
Female
Heart Block - diagnosis
Heart Block - prevention & control
Heart failure
Heart Ventricles
Humans
Male
Prognosis
QRS duration
Right ventricular pacing
Statistics as Topic
Ventricular Dysfunction, Left - diagnosis
Ventricular Dysfunction, Left - therapy
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Summary:Abstract Introduction Prolonged paced QRS duration is a predictor of development of heart failure during chronic right ventricular pacing. One determinant of paced QRS width might be His-Purkinje system dysfunction, manifested in wide native (escape or conducted beat) QRS complexes in patients with atrioventricular (AV) block. Methods Fifty patients with normal left ventricular function who are undergoing implantation of a pacemaker for AV block were enrolled. The duration of the QRS complex was measured on the surface electrocardiogram during escape rhythm in 28 patients with total AV block and during conducted beats in 22 patients with second-degree, fixed ratio (2:1 or 3:1) AV block, as well as during ventricular paced rhythm after pacemaker implantation in all patients. Results A close, positive correlation was found between native and paced QRS duration in the second-degree AV block group ( R = 0.74, P < .001). This association was also significant but less pronounced in the total AV block group ( R = 0.46, P = .014). Conclusion Native QRS width, especially in case of fixed ratio (2:1 or 3:1) second-degree AV block, is a predictor of paced QRS duration in patients with AV block and normal left ventricular function. Wide QRS complex before implantation may carry a higher risk of developing heart failure with right ventricular pacing.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2006.10.060