학술논문

Early prediction of cardiac resynchronization therapy response by non-invasive electrocardiogram markers.
Document Type
Journal Article
Source
Medical & Biological Engineering & Computing. Apr2018, Vol. 56 Issue 4, p611-621. 11p. 4 Charts, 5 Graphs.
Subject
*CARDIAC pacing
*ELECTROCARDIOGRAPHY
*HEART failure patients
*CARDIOMYOPATHIES
*COST effectiveness
*TREATMENT of cardiomyopathies
*HEART failure
*RESEARCH funding
*TREATMENT effectiveness
*PREDICTIVE tests
*RETROSPECTIVE studies
Language
ISSN
0140-0118
Abstract
Cardiac resynchronization therapy (CRT) is an effective treatment for those patients with severe heart failure. Regrettably, there are about one third of CRT "non-responders", i.e. patients who have undergone this form of device therapy but do not respond to it, which adversely affects the utility and cost-effectiveness of CRT. In this paper, we assess the ability of a novel surface ECG marker to predict CRT response. We performed a retrospective exploratory study of the ECG previous to CRT implantation in 43 consecutive patients with ischemic (17) or non-ischemic (26) cardiomyopathy. We extracted the QRST complexes (consisting of the QRS complex, the S-T segment, and the T wave) and obtained a measure of their energy by means of spectral analysis. This ECG marker showed statistically significant lower values for non-responder patients and, joint with the duration of QRS complexes (the current gold-standard to predict CRT response), the following performances: 86% accuracy, 88% sensitivity, and 80% specificity. In this manner, the proposed ECG marker may help clinicians to predict positive response to CRT in a non-invasive way, in order to minimize unsuccessful procedures. [ABSTRACT FROM AUTHOR]