Early prediction of cardiac resynchronization therapy response by non-invasive electrocardiogram markers

• Published in: Medical & biological engineering & computing Vol. 56; no. 4; pp. 611 - 621
• Main Authors: Ortigosa, Nuria, Pérez-Roselló, Víctor, Donoso, Víctor, Osca, Joaquín, Martínez-Dolz, Luis, Fernández, Carmen, Galbis, Antonio
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2018; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Cardiomyopathy; Computer Applications; EKG; Electrocardiography; Energy measurement; Heart; Heart diseases; Heart failure; Human Physiology; Imaging; Implantation; Ischemia; Original Article; Patients; Radiology; Spectral analysis; Statistical analysis; Therapy; Heart failure; Cardiac resynchronization therapy; Electrocardiogram
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-017-1711-1

Cardiac resynchronization therapy (CRT) is an effective treatment for those patients with severe heart failure. Regrettably, there are about one third of CRT “non-responders”, i.e. patients who have undergone this form of device therapy but do not respond to it, which adversely affects the utility and cost-effectiveness of CRT. In this paper, we assess the ability of a novel surface ECG marker to predict CRT response. We performed a retrospective exploratory study of the ECG previous to CRT implantation in 43 consecutive patients with ischemic (17) or non-ischemic (26) cardiomyopathy. We extracted the QRST complexes (consisting of the QRS complex, the S-T segment, and the T wave) and obtained a measure of their energy by means of spectral analysis. This ECG marker showed statistically significant lower values for non-responder patients and, joint with the duration of QRS complexes (the current gold-standard to predict CRT response), the following performances: 86% accuracy, 88% sensitivity, and 80% specificity. In this manner, the proposed ECG marker may help clinicians to predict positive response to CRT in a non-invasive way, in order to minimize unsuccessful procedures.