Clinical Electrophysiology -> Syncope & Bradycardia: -> Electrocardiography and Monitoring D-PO05 - Poster Session V (ID 39) Poster

D-PO05-217 - Reverse Electrophysiological Remodeling Following Continuous-flow Left Assisted Ventricular Device Implantation Predicts Myocardial Recovery In Chronic Heart Failure Patients (ID 598)


Background: We examined the continuous flow left ventricular assist device (LVAD) support on myocardial electrophysiological parameters (QRS, QT and QTc).
Objective: Investigate whether the continuous flow LVAD may cause shortening of the QRS, QT and QTc segments and improve LV reverse remodeling early after its implantation.
Methods: QRS, QT and QTc were studied retrospectively before (baseline) and after (week 4) implanting LVAD in 83 chronic heart failure patients. Cardiac recovery post-LVAD implantation was followed up to 12 months and defined as (i) Responder (R): follow-up LV-ejection fraction (LVEF) ≥ 40% and LV-internal diastolic diameter (LVIDd) ≤ 6.0 cm, (ii) Partial-Responder (PR): follow-up LVEF < 40%, LVIDd < or > 6.0 cm, absolute LVEF increase > 10% from baseline, (iii) Borderline-Responder (BR): follow-up LVEF < 40%, LVIDd < or > 6.0 cm, absolute LVEF increase 5-10% from baseline, and (iv) Non-Responder (NR): follow-up LVEF < 40%, LVIDd < or > 6.0 cm, absolute LVEF increase < 5% from baseline.
Results: At week 4, Post-LVAD QRS, QT and QTc were decreased from 143±35 to 119±31 ms (p<0.001, AUC:0.688), 399±66 to 353±73 ms (p<0.001, AUC:0.707), and 478±69 to 454±76 ms (p=0.011, AUC:0.614) respectively, in comparison their pre-LVAD values. QT showed a higher accuracy in predicting the myocardial recovery in PR (p=0.017, AUC:0.756), BR (p=0.021, AUC:0.789) and NR (p<0.001, AUC:0.695) groups. QRS exhibited a myocardial recovery prediction for PR (p=0.031, AUC:0.731) and NR (p<0.001, AUC:0.709), but not for the BR (p=0.178, AUC:0.669).
Conclusion: Results showed early significant improvements in reverse electrophysiologic remodeling at week 4 of the LVAD implant.