The Relationship Between Fragmented QRS Complexes And Cardiac Resynchronization Therapy Curative Effect

Objective: To observe the correlation between the patients with f QRS on the ECG and the therapeutic effect of cardiac resynchronization,and to explore the predictive value of f QRS for CRT prognosis.Methods: Continuous collected from January 2015 to Jun 2017,our hospital(the first affiliated hospital of Wannan Medical College)undergo CRT therapy for chronic congestive heart failure cases as the research object,a total of 33 cases,including 18 cases of CRT,15 cases of the CRT-D,ruled out four CRT/CRT-D,a DDD upgraded to CRT replacement patients,a hisbundle pacing of patients + CRT-D.The parameters of echocardiography and other cardiac function were measured before and after CRT operation.SPSS25.0 was used to statistical analysis,for continuous data,two groups to compare the data of each index of normality test and f test,if accord with normality,its central tendency and dispersion.The mean + /-standard deviation statistical description,such as is not in conformity with the normality,with median + quarterback spacing for statistical description.If it does not conform to the normal state,the comparison between the two groups takes non-parametric test,and P < 0.05 indicates that there is a statistical difference between the two groups.For the dichotomous data,the comparison between the two groups was conducted with the chi 2 test,assuming that P < 0.05 indicates that there is a difference between the two groups.Logistic regression was used for single factor analysis to calculate the OR value and 95% confidence interval,and P < 0.05 was considered statistically significant.Results: All patients were operated successfully.There were no acute left heart failure,severe ventricular arrhythmia,coronary interlayer,pericardial embolism,etc.According to the electrocardiogram(ECG)with or without f QRS wave division into two groups,f QRS wave group and non f QRS wave group,two groups in age,gender,history of hypertension,diabetes,hyperlipidemia,heart function NYHA classification,clinical medicine(ARB/ACEI,diuretics,beta blockers,digitalis)aspects of no significant difference(p > 0.05).The proportion of ischemic cardiomyopathy in f QRS group was significantly higher than that in non-fqrs group(p < 0.05).Before cardiac resynchronization therapy,there was no significant difference between the left ventricular function parameters(LVEF)and serum BNP(p BBB 0 0.05).After the treatment of CRT,there were significant differences between the two groups(p<0.05).The single factor regression analysis indicated that f QRS was an independent risk factor after CRT.Conclusions: In patients with ischemic cardiomyopathy is easier to appear fQRS wave,CRT curative effect is better than that of patients without f QRS wave group f QRS wave group of patients,f QRS wave are independent risk factors of the CRT has no reaction,can be used as a reference index screening of CRT patients.