Abstract
Background
This study investigated the predictive value of preoperative QRS duration (ORSd) in responsiveness of chronic heart failure (CHF) patients with pacemaker indications to the left bundle branch area pacing (LBBAP).
Methods
Thirty-one CHF patients with cardiac function categorized as NYHA class II or above and indications for pacemaker therapy who successfully underwent LBBAP treatment were enrolled in this study. Based on the 12-month postoperative responsiveness to treatment, patients were divided into a responsiveness group (n=18) and a no-responsiveness group (n=13). Data from all patients were collected for analysis. Multivariate binary logistic regression analysis was used to determine the independent factors associated with the responsiveness to LBBAP treatment.
Results
Among the 31 patients with LBBAP, 16 patients (51.6%) responded to the treatment, and 15 patients (48.4%) had no response. There were significant differences between these two groups with regard to complete left bundle branch block (CLBBB), preoperative QRSd, and preoperative left ventricular peak time (LVAT). Univariate logistic regression analysis showed that CLBBB, preoperative QRSd, and preoperative LVAT were all significantly correlated with responsiveness to LBBAP. Multivariate binary logistic regression analysis showed that ORSd was an independent predictor of responsiveness to LBBAP. The maximum area under the ROC curve for QRSd was 0.827, the maximum Youden index was 0.679, with the optimal cutoff point of QRSd ≥ 153 ms, a sensitivity of 81.3%, and a specificity of 86.7%.
Conclusion
Preoperative ORSd predicts the responsiveness of CHF patients with pacemaker indications to LBBAP.
Impact of QRS duration on left ventricular remodelling and survival in patients with chronic heart failure