Selection of patient for cardiac resynchronization therapy: role of QT corrected dispersion

Aims: About 30 to 50% of patients undergoing cardiac resynchronization therapy (CRT) may not showclinical or echocardiographic improvement, despite fulfilling guidelines recommendations for CRT. Forthis reason, we need a more accurate method to assess CRT eligibility. The aims of this study were toverify, on a 12-month follow-up, the usefulness of QT corrected dispersion (QTcD) in a patient’s selectionfor CRT.Methods: We stratified 53 patients who underwent CRT, into two groups based on the estimation ofQTcD, that is, QTcD > 60 ms and QTcD ≤ 60 ms. In all patients were performed New York HeartAssociation (NYHA) class determination, six-minute walking test, QtcD, and QRS measurements, andcomplete echocardiographic assessment at 1, 3, 6, and 12 months after implantation.Results: At baseline, there were no significant differences in clinical, echocardiographic, andelectrocardiographic parameters duration between two groups. At 12-month follow-up between the twogroups, there were significant differences in NYHA (1.2 ± 0.4 vs 2 ± 0.6; P < 0.01), six-minute walkingdistance (422 ± 68 vs 364 ± 68; P < 0.01), left ventricular (LV) ejection fraction (34 ± 7% vs 28 ± 6%; P <0.01), LV end-diastolic diameter (57 ± 7 vs 63 ± 8; P < 0.01), and LV intraventricular dyssynchrony (24± 14 vs 39 ± 23; P < 0.01).Conclusion: This study suggests that QTc dispersion in addition to QRS duration could improve thesensitivity of electrocardiogram in a patient’s selection for CRT.