Use of T-wave duration and Tpeak-Tend interval as new prognostic markers for patients treated with cardiac resynchronization therapy

Abstract

Background: The use of electrocardiography (ECG) is a practical method to evaluate the response to cardiac resynchronization therapy (CRT) implantation, as it is easily performed and saves time.
Aim: This study aimed to assess the predictive value of the T-wave duration and Tpeak-Tend (Tp-e) interval following the CRT implantation administered to heart failure patients.
Methods: Sixty-seven patients with left ventricular ejection fraction ≤35, New York Heart Association (NYHA) class II–III, ambulatory class IV, normal sinus rhythm, who have complete left bundle branch block on ECG and treated with CRT were included in this study. Patients who have manifested a ≥10% improvement in ejection fraction following CRT implantation, were categorized as “responders”, and the remaining patients were categorized as “non-responders”. ECGs and echocardiograms were evaluated both six months before and after CRT implantation.
Results: The post-CRT QRS duration (P = 0.01), cQT interval (P = 0.005), T-wave (P <0.001), and Tp-e interval (P <0.001) were found to be significantly reduced in the responder group compared to the non-responder group. The receiver operating characteristics curve analyses revealed that the predictive optimal cut-off of the T-wave was <182 ms (P <0.001), and that of the Tp-e interval was <92 ms (P <0.001).
Conclusions: T-wave and Tp-e interval may be independent predictors of a favorable CRT response in heart failure patients.