Journal of Cardiac Failure
Volume 16, Issue 3 , Pages 239-243, March 2010

Native and Paced QRS Duration in Right Ventricular Apex Paced Patients

  • Wenzhi Pan, MD

      Affiliations

    • Drs Wenzhi Pan and Yangang Su contributed equally to this work.
    • ,
  • Yangang Su, MD

      Affiliations

    • Drs Wenzhi Pan and Yangang Su contributed equally to this work.
    • ,
  • Aijun Sun, PhD
    • ,
  • Xue Gong, MD
    • ,
  • Junbo Ge, MD

      Affiliations

    • Corresponding Author InformationReprint requests: Junbo Ge, MD, Department of Cardiology, Zhongshan Hospital, No. 180, Fenglin Road, Shanghai, 200032, China. Tel: 86-021-64041990-2745; Fax: 86-021-64223006.

Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China

Received 16 August 2009; received in revised form 11 October 2009; accepted 15 October 2009. published online 11 December 2009.

Abstract 

Background

The value between paced QRS duration (pQRSd) and native QRS duration (nQRSd) in paced population has not been compared. The relation between nQRSd and pQRSd remains undefined now.

Methods and Results

A total of 310 right ventricular apex (RVA) paced patients were enrolled. The correlation coefficients between nQRSd and pQRSd to left ventricular (LV) dimensions and ejection fraction (LVEF) were calculated and then compared. The association between pQRSd and nQRSd was examined. pQRSd was better correlated with LVDD, LVDS, and LVEF than nQRSd in all patients or patients with no intraventricular conduction block (NIVCB, n = 136) or complete right bundle-branch block (CRBB, n = 86) (all P < .01). pQRSd was positively correlated with nQRSd in NIVCB, CRBB, and complete left bundle-branch block (CLBB, n = 45) patients (r = 0.408, 0.465, and 0.766, respectively; all P < .001). However, pQRSd was not different between NIVCB, CRBB, and CLBB patients (P > .05) after adjusting for LVEF and LV dimensions.

Conclusions

pQRSd is superior to nQRSd in terms of reflecting LV structures and function in RVA-paced patients. Bundle branch block (BBB) has no significant effect on pQRSd and thus further studies are needed to clarify whether BBB is an independent risk factor for the development of heart failure after RVA pacing.

Key Words: Paced, QRS duration, left ventricular ejection fraction, right ventricular apex

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 The authors have no conflicts to disclose.

PII: S1071-9164(09)01131-2

doi:10.1016/j.cardfail.2009.10.021

Journal of Cardiac Failure
Volume 16, Issue 3 , Pages 239-243, March 2010

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