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Prognostic implication of baseline PR interval in cardiac resynchronization therapy recipients
- Source :
- Heart Rhythm. 12:2256-2262
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Background Prolongation of the baseline ECG PR interval is frequently encountered among cardiac resynchronization therapy (CRT) recipients. There are conflicting data regarding the association of a prolonged PR interval with long-term clinical outcome in this patient group. Objective The purpose of this study was to compare clinical outcomes and response to CRT in patients with normal ( Methods In this study, 283 patients (normal PR interval: n=158; prolonged PR interval: n=125) with documented baseline intrinsic PR interval were followed for 3 years after CRT implantation. The study population consisted of 24.7% women (mean age 66 ± 13 years, left ventricular ejection fraction 24% ± 7%). Results A Cox proportional hazard model identified baseline PR interval as a predictor of the composite end-point (all-cause mortality, heart failure hospitalization, left ventricular assist device implantation, and heart transplantation) in univariate analysis (hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.02–2.17, P = .04) but not in multivariate analysis. It also predicted heart failure hospitalization in univariate (HR 1.6, 95% CI 1.1–2.4, P = .02) and multivariate analysis (HR 1.6, 95% CI 1.0–2.3, P = .03). A prolonged PR interval was associated with lower probability of reverse remodeling defined as ≥10% improvement in ejection fraction (64% vs 77%, P = .057), especially in patients with non–left bundle branch block ECG morphology (41% vs 68%, P = .03). Conclusion Among patients with CRT, a prolonged baseline PR interval is an independent predictor of worse prognosis and lower probability of reverse remodeling, especially for patients with non–left bundle branch block morphology on ECG.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Bundle-Branch Block
Cardiac resynchronization therapy
Kaplan-Meier Estimate
Risk Assessment
Cardiac Resynchronization Therapy
Electrocardiography
Sex Factors
Predictive Value of Tests
Physiology (medical)
Internal medicine
Humans
Medicine
PR interval
Aged
Retrospective Studies
Heart Failure
Analysis of Variance
Ejection fraction
Bundle branch block
business.industry
Left bundle branch block
Hazard ratio
Age Factors
Middle Aged
medicine.disease
Confidence interval
Electrodes, Implanted
Survival Rate
Treatment Outcome
First-degree atrioventricular block
Case-Control Studies
Multivariate Analysis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15475271
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Heart Rhythm
- Accession number :
- edsair.doi.dedup.....5dfe0cb92fa2cabbb3944f8882d423b2