RELATIONSHIP BETWEEN THE QRS COMPLEX DURATION AND CLINICAL MANIFESTATION OF ATRIAL FIBRILLATION
Keywords:
QRS complex duration, atrial fibrillation, prolonged QRS complex, shortened QRS complex
Abstract
Relationship between the QRS complex duration (QRSD) and clinical manifestation of atrial fibrillation (AF) was studied in 126 patients mean age (65±10) years with duration of the disease (6±5) years. In study population the range of QRSD was (65-190) ms. Of these patients, 54 % had prolonged QRS complexes, shortened QRS complexes were absent. The frequency of intraventricular blocks in patients with normal QRS complex was 14% and with prolonged – 41%. Patients with prolonged QRS complex and intraventricular blocks had more severe clinical manifestation of AF, than without blocks. Left bundle branch block and bifascicular block were associated with more severe clinical manifestation of AF than other types of intraventricular blocks. QRS complex prolongation was associated with the increase in severity of heart failure and arterial hypertension, left atrial anteroposterior diameter, left ventricular (LV) end-diastolic diameter, LV posterior wall thickness and decrease of the LV ejection fraction and heart rate.
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References
1. Management of atrial fibrillation in patients with heart failure / H.R. Neuberger, C. Mewis, J. van Veld-huisen D. [et al.] // European Heart Journal. – 2007. – № 28(21). – P. 2568–2577.
2. Lin Y. Incremental Changes in QRS Duration Predict Mortality in Patients with Atrial Fibrillation / Y. Lin, Y. Liu, C. Chu // Pacing Clin Electrophysiol. – 2009. – № 32(11). – P. 1388–1394.
3. Predictors of arrhythmia recurrence in patients with lone atrial fibrillation / G. Arriagada, A. Berruezo, L. Mont [et al.] // Europace. – 2008. –№ 10(1). – P. 9–14.
4. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study / J. Heeringa, D. Kuip, A. Hofman [et al.] // European Heart Journal. – 2006. – № 27(8) . – P. 949–953.
5. The Relationship Between Stature and the Prevalence of Atrial Fibrillation in Patients With Left Ventric-ular Dysfunction / I. Hanna, B. Heeke, H. Bush [et al.] // J Am Coll Cardiol. – 2006. – № 47. – P. 1683–1688.
6. Is a narrow and tall QRS complex an ECG marker for sudden death? / C. Wolpert, C. Veltmann, I. Gussak [et al.] // Heart Rhythm. – 2008. – № 5. – P. 1339–1345.
7. Cross-sectional relations of electrocardiographic QRS duration to left ventricular dimensions. The Fram-ingham Heart Study / R. Dhingra, B. Ho Nam, E. Benjamin [et al.] // J Am Coll Cardiol. – 2005. – № 45. – P. 685–689.
8. Jeevanantham V. Cardiac resynchronization therapy in heart failure patients: an update / V. Jeevanan-tham, J.P. Daubert, W. Zareba // Cardiol J. – 2009. – № 16(3). – P. 197–209.
9. Left ventricular dyssynchrony evaluated by echocardiography in chronic heart failure patients with nor-mal and wide QRS duration / Y.G. Sun, W.F. Shen, F.R. Zhang [et al.] // Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases]. – 2008. – № 36(1). – P. 44–48.
10. Prevalence of mechanical dyssynchrony in heart failure patients with different QRS durations / M. Haghjoo, A. Bagherzadeh, A.F. Fazelifar [et al.] // Pacing Clin Electrophysiol. – 2007. – № 30(5). – P. 616–622.
11. QRS and QTc interval prolongation in the prediction of long-term mortality of patients with acute desta-bilised heart failure / T. Breidthardt, M. Christ, M. Matti [et al.] // Heart. – 2007. – № 93. – P. 1093–1097.
12. Frequency of inter- and intraventricular dyssynchrony in patients with heart failure according to QRS width / Z. Emkanjoo1, M. Esmaeilzadeh, M. Hadi1 [et al.] // Europace. – 2007. – № 9(12). – P. 1171–1176.
13. Prolonged QRS Duration and Severity of Mitral Regurgitation are Unfavorable Prognostic Markers of Heart Failure in Patients With Nonischemic Dilated Cardiomyopathy / E. Amiya, K. Tanabe, Y. Ikari [et al.] // Circulation Journal. – 2006. – № 70. – P. 57–62.
14. Congestive heart failure and QRS duration establishing prognosis study/ H.J. Shenkman, V. Pampati, A.K. Khandelwal [et al.] // Chest. – 2002. – № 122. – P. 528–534.
15. Grigioni F. Prolonged QRS and QTc interval and mortality / F. Grigioni, G. Piovaccari, G.Boriani // Heart. – 2007. – № 93(9). – P. 1093–1097.
16. Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration / A.F. Fazelifar, H.R. Bonakdar, K. Alizadeh [et al.] // Cardiol J. – 2008. – № 15(4). – Р. 351–356.
17. Wang N.C. Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction / N.C. Wang, A.P. Maggioni, A. Marvin // JAMA. – 2008. – № 299(22). – P. 2656–2666.
18. Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure / S. Baldasseronia, De Biaseb L., C. Frescoc [et al.] // European Heart Journal. – 2002. – № 23(21). – P. 1692–1698.
19. Features of an exceptionally narrow QRS data set / R. Childers, A. Holmes, M. Kocherginsky [et al.] / Journal of Electrocardiology. – 2008. – № 41. – P. 501–507.
20. Moss A.J. Do «narrow and tall» QRS complexes «stand tall» and have arrhythmogenic implications? / A.J. Moss // Heart Rhythm. – 2008. – № 5. – № 9. – P. 1346–1346.
21. Significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure patients eligible for cardiac resynchronization: particular focus on patients with right bundle branch block with and without coexistent left-sided conduction defects / M. Haghjoo, A. Bagherzadeh, M.M. Farahani [et al.] // Europace. – 2008. – № 10(5). – P. 566–571.
22. Varma N. Left ventricular conduction delays and relation to QRS configuration in patients with left ven-tricular dysfunction / N. Varma // Am J Cardiol. – 2009. – № 103(11). – P. 1578–1585.
2. Lin Y. Incremental Changes in QRS Duration Predict Mortality in Patients with Atrial Fibrillation / Y. Lin, Y. Liu, C. Chu // Pacing Clin Electrophysiol. – 2009. – № 32(11). – P. 1388–1394.
3. Predictors of arrhythmia recurrence in patients with lone atrial fibrillation / G. Arriagada, A. Berruezo, L. Mont [et al.] // Europace. – 2008. –№ 10(1). – P. 9–14.
4. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study / J. Heeringa, D. Kuip, A. Hofman [et al.] // European Heart Journal. – 2006. – № 27(8) . – P. 949–953.
5. The Relationship Between Stature and the Prevalence of Atrial Fibrillation in Patients With Left Ventric-ular Dysfunction / I. Hanna, B. Heeke, H. Bush [et al.] // J Am Coll Cardiol. – 2006. – № 47. – P. 1683–1688.
6. Is a narrow and tall QRS complex an ECG marker for sudden death? / C. Wolpert, C. Veltmann, I. Gussak [et al.] // Heart Rhythm. – 2008. – № 5. – P. 1339–1345.
7. Cross-sectional relations of electrocardiographic QRS duration to left ventricular dimensions. The Fram-ingham Heart Study / R. Dhingra, B. Ho Nam, E. Benjamin [et al.] // J Am Coll Cardiol. – 2005. – № 45. – P. 685–689.
8. Jeevanantham V. Cardiac resynchronization therapy in heart failure patients: an update / V. Jeevanan-tham, J.P. Daubert, W. Zareba // Cardiol J. – 2009. – № 16(3). – P. 197–209.
9. Left ventricular dyssynchrony evaluated by echocardiography in chronic heart failure patients with nor-mal and wide QRS duration / Y.G. Sun, W.F. Shen, F.R. Zhang [et al.] // Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases]. – 2008. – № 36(1). – P. 44–48.
10. Prevalence of mechanical dyssynchrony in heart failure patients with different QRS durations / M. Haghjoo, A. Bagherzadeh, A.F. Fazelifar [et al.] // Pacing Clin Electrophysiol. – 2007. – № 30(5). – P. 616–622.
11. QRS and QTc interval prolongation in the prediction of long-term mortality of patients with acute desta-bilised heart failure / T. Breidthardt, M. Christ, M. Matti [et al.] // Heart. – 2007. – № 93. – P. 1093–1097.
12. Frequency of inter- and intraventricular dyssynchrony in patients with heart failure according to QRS width / Z. Emkanjoo1, M. Esmaeilzadeh, M. Hadi1 [et al.] // Europace. – 2007. – № 9(12). – P. 1171–1176.
13. Prolonged QRS Duration and Severity of Mitral Regurgitation are Unfavorable Prognostic Markers of Heart Failure in Patients With Nonischemic Dilated Cardiomyopathy / E. Amiya, K. Tanabe, Y. Ikari [et al.] // Circulation Journal. – 2006. – № 70. – P. 57–62.
14. Congestive heart failure and QRS duration establishing prognosis study/ H.J. Shenkman, V. Pampati, A.K. Khandelwal [et al.] // Chest. – 2002. – № 122. – P. 528–534.
15. Grigioni F. Prolonged QRS and QTc interval and mortality / F. Grigioni, G. Piovaccari, G.Boriani // Heart. – 2007. – № 93(9). – P. 1093–1097.
16. Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration / A.F. Fazelifar, H.R. Bonakdar, K. Alizadeh [et al.] // Cardiol J. – 2008. – № 15(4). – Р. 351–356.
17. Wang N.C. Clinical Implications of QRS Duration in Patients Hospitalized With Worsening Heart Failure and Reduced Left Ventricular Ejection Fraction / N.C. Wang, A.P. Maggioni, A. Marvin // JAMA. – 2008. – № 299(22). – P. 2656–2666.
18. Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure / S. Baldasseronia, De Biaseb L., C. Frescoc [et al.] // European Heart Journal. – 2002. – № 23(21). – P. 1692–1698.
19. Features of an exceptionally narrow QRS data set / R. Childers, A. Holmes, M. Kocherginsky [et al.] / Journal of Electrocardiology. – 2008. – № 41. – P. 501–507.
20. Moss A.J. Do «narrow and tall» QRS complexes «stand tall» and have arrhythmogenic implications? / A.J. Moss // Heart Rhythm. – 2008. – № 5. – № 9. – P. 1346–1346.
21. Significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure patients eligible for cardiac resynchronization: particular focus on patients with right bundle branch block with and without coexistent left-sided conduction defects / M. Haghjoo, A. Bagherzadeh, M.M. Farahani [et al.] // Europace. – 2008. – № 10(5). – P. 566–571.
22. Varma N. Left ventricular conduction delays and relation to QRS configuration in patients with left ven-tricular dysfunction / N. Varma // Am J Cardiol. – 2009. – № 103(11). – P. 1578–1585.
How to Cite
BurdаІ. (1). RELATIONSHIP BETWEEN THE QRS COMPLEX DURATION AND CLINICAL MANIFESTATION OF ATRIAL FIBRILLATION. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (19), 31-37. Retrieved from https://periodicals.karazin.ua/medicine/article/view/6934
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