Limitations because of wide duration of this study should be considered.
In this cohort, and not dissimilar to other reports [ 9], a wide duration of symptoms prior to diagnosis was recorded; the median duration of symptoms of 5 months suggests that an acute presentation is not common.
Current guidelines recommend CRT implantation in a broad spectrum of patients with advanced heart failure, systolic dysfunction, and wide QRS duration.
The European Society of Cardiology has extended its recommendation for CRT to patients with NYHA class II symptoms, LVEF of 35% or less, wide QRS duration of 150 ms or more, and sinus rhythm [ 35].
Cardiac resynchronization therapy (CRT) is an established therapy in patients with drug-refractory HF and wide QRS duration, providing significant improvement of symptoms, left ventricular (LV) function, and long-term morbidity and mortality.
Both forms of RV apical pacing were associated with a significantly wider QRS duration than occurred during AAI pacing, though there was no significant difference in QRS duration when comparing the alternate pacing sites (RVA to RValt −20 ms, P = 0.11; RVA to RValt −40 ms, P = 0.07).
Those ineligible for the TWA test were older, were associated with more severe heart failure symptoms, had higher BNP levels, had a wider QRS duration, and had a higher prevalence of AF or digitalis use as compared with TWA-negative patients.
As a result, ICD patients were much sicker than Non-ICD patients in terms of lower systolic blood pressure, higher BNP level, lower LVEF, larger LVEDD, wider QRS duration, lower prevalence of negative-TWA, and higher prevalence of moderate to severe mitral regurgitation, PVC >10/h, or NSVT (data not shown).
Although this is an acute study, our findings open the scope for revising the current wide QRS duration as an indication for CRT and to consider the less expensive LV rather than BIV pacing when a patient is considered a candidate for resynchronization.
Teams of 14 outfield players and a goalkeeper play on a rectangular grass pitch 145 m long and 90 m wide, for durations of 60 70 min per game. 2 The aim is to score by sending the ball between the opposition's goal posts.
