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QRS Duration to Predict Mortality Risk in Patient with ICD & Heart Failure

Purpose: To predict the mortality rate in a patient with an implantable cardioverter defibrillator (ICD) and NYHA Class III heart failure.

Description

Bode-Schnurbus et al evaluated QRS duration as a marker for death in patients with an implantable cardioverter defibrillator (ICD) and heart failure. This can help identify patients who may benefit from closer monitoring and more aggressive therapy. The authors are from the University of Heidelberg in Mannheim.


 

Patient selection:

(1) heart failure with reduced left ventricular ejection fraction

(2) NYHA functional class III

(3) ICD placed for sudden cardiac arrest, sustained ventricular tachycardia or syncope

 

Parameters:

(1) QRS duration in milliseconds (ms)

(2) left ventricular ejection fraction

 

QRS Duration

LVEF

Cardiac Mortality Rate

< 150 ms

> 35%

17.9%

< 150 ms

<= 35%

20.5%

>= 150 ms

> 35%

22.2%

>= 150 ms

<= 35%

29.4%

from data in Figure 4, page 1160.

 

where:

• NYHA Class III heart failure indicates impaired activity level with symptoms on ordinary physical activity but comfortable at rest (see Chapter 37).

 


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Specialty

Objective

ICD-10