Prognostic implication of baseline PR interval in cardiac resynchronization therapy recipients
(2015) In Heart Rhythm 12(11). p.62-2256- 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 (<200 ms) vs prolonged (≥200 ms) baseline PR interval.
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... (More)
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 (<200 ms) vs prolonged (≥200 ms) baseline PR interval.
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.
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- author
- Januszkiewicz, Łukasz ; Vegh, Eszter ; Borgquist, Rasmus LU ; Bose, Abhishek ; Sharma, Ajay ; Orencole, Mary ; Mela, Theofanie ; Singh, Jagmeet P and Parks, Kimberly A
- publishing date
- 2015-11
- type
- Contribution to journal
- publication status
- published
- keywords
- Age Factors, Aged, Analysis of Variance, Bundle-Branch Block, Cardiac Resynchronization Therapy, Case-Control Studies, Electrocardiography, Electrodes, Implanted, Female, Follow-Up Studies, Heart Failure, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Sex Factors, Survival Rate, Treatment Outcome, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't
- in
- Heart Rhythm
- volume
- 12
- issue
- 11
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:84945439473
- pmid:26066291
- ISSN
- 1547-5271
- DOI
- 10.1016/j.hrthm.2015.06.016
- language
- English
- LU publication?
- no
- id
- 30ebe57b-1833-4db6-a9a3-bf1a11ad2ed5
- date added to LUP
- 2016-11-24 21:18:11
- date last changed
- 2024-05-31 17:52:24
@article{30ebe57b-1833-4db6-a9a3-bf1a11ad2ed5, abstract = {{<p>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.</p><p>OBJECTIVE: The purpose of this study was to compare clinical outcomes and response to CRT in patients with normal (<200 ms) vs prolonged (≥200 ms) baseline PR interval.</p><p>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%).</p><p>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).</p><p>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.</p>}}, author = {{Januszkiewicz, Łukasz and Vegh, Eszter and Borgquist, Rasmus and Bose, Abhishek and Sharma, Ajay and Orencole, Mary and Mela, Theofanie and Singh, Jagmeet P and Parks, Kimberly A}}, issn = {{1547-5271}}, keywords = {{Age Factors; Aged; Analysis of Variance; Bundle-Branch Block; Cardiac Resynchronization Therapy; Case-Control Studies; Electrocardiography; Electrodes, Implanted; Female; Follow-Up Studies; Heart Failure; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Sex Factors; Survival Rate; Treatment Outcome; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't}}, language = {{eng}}, number = {{11}}, pages = {{62--2256}}, publisher = {{Elsevier}}, series = {{Heart Rhythm}}, title = {{Prognostic implication of baseline PR interval in cardiac resynchronization therapy recipients}}, url = {{http://dx.doi.org/10.1016/j.hrthm.2015.06.016}}, doi = {{10.1016/j.hrthm.2015.06.016}}, volume = {{12}}, year = {{2015}}, }