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Electrical Dyssynchrony Studied in Heart Failure Patients

Prolonged QRS duration independently predicts high rate of morbidity and mortality

TUESDAY, June 10 (HealthDay News) -- Patients with reduced left ventricular ejection fraction who are hospitalized for worsening heart failure are likely to have a prolonged QRS duration, which is an independent risk factor for high rates of post-discharge morbidity and mortality, researchers report in the June 11 issue of the Journal of the American Medical Association.

Norman C. Wang, M.D., of Northwestern University Feinberg School of Medicine in Chicago, and colleagues analyzed data from 2,962 patients hospitalized with heart failure at 359 sites in North America, South America and Europe between 2003 and 2006. Patients with a pacemaker, implantable cardioverter defibrillator or both were excluded from the cohort. While 1,641 patients had a normal QRS duration (less than 120 ms), 1,321 had a prolonged QRS duration.

The cohort was followed up for a median 9.9 months, during which time 18.7 percent of the normal QRS duration group died, versus 28.1 percent for the prolonged QRS duration group. The composite rate of cardiovascular death or hospitalization for heart failure was 32.4 for the normal QRS duration group and 41.6 percent for the prolonged QRS duration group.

"Further studies are needed to assess whether implantation of a cardiac resynchronization therapy device with or without an implantable cardioverter defibrillator before or soon after discharge from a hospitalization for heart failure can reduce morbidity and mortality," the authors write.

Several of the study co-authors disclosed financial ties to pharmaceutical companies.

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