Retrospective Analysis Of The Incidence Of Prolonged QRSd And The Status Of CRT Implantation In Patients With Chronic Congestive Heart Failure

BackgroundHeart failure（HF）is a group of complex clinical syndromes caused by abnormal changes in cardiac structure and/or function resulting in ventricular systolic and/or diastolic dysfunction.At present,new treatment measures for refractory HF patients emerge one after another,but some patients have not been systematically treated.Cardiac resynchronization therapy（CRT）,as an effective treatment for part of refractory HF patients,has been carried out in many centers in China,but there is a lack of data for many HF patients with CRT implantation in China.Little is known about the incidence of HF patients who meet the indications for CRT implantation and the RATE of CRT implantation in the real world.It is of great significance to understand the status of CRT treatment in HF patients.ObjectiveTo discuss:（1）Differences in the prevalence of HF with（Left bundle branch block,LBBB）or（Intraventricular conduction delay,IVCD）in different age groups;（2）Differences in survival of HF patients with LBBB or IVCD in different age groups;（3）For patients with HF meeting the CRT indication,patients with CRT implantation had a better survival rate than those without CRT implantation.Methods1.A total of 5452 HF inpatients from the Heart Center of the First Affiliated Hospital of Tsinghua University（Beijing Huaxin Hospital）and the Department of Cardiology of Weishi County Central Hospital were studied.A total of 1644 cases of Left ventricular ejection fraction were included.LVEF)<40%of HF patients,Among the 1554 patients without CRT implantation,a total of 679 patients met the indications for CRT implantation,including only 90 patients with CRT implantation,589 patients with indications but without CRT implantation,and 965 patients without CRT indication.2.All the enrolled patients were divided into three age groups of 65 years old,65-79years old and 80 years old according to age.3.SPSS 20.0 and Graphad Prism 9.0 were used to analyze and plot clinical data,and mean standard deviation（（?）±s）was used for measurement data,two independent samples t-test was used for inter-group comparison,counting data were expressed as percentages,and The Chi-square test（χ~2）was used for inter-group comparison.Kaplan-meier（K-M）survival curve was drawn to understand the all-cause mortality of patients.Results1.Among 1644 HF patients（LVEF<40%）,the prevalence of LBBB in the three age groups was 10%vs 13%vs 15%,and the prevalence of IVCD was 25%vs 29%vs 34%,respectively（P<0.05）.2.In the three age groups aged 65 years,65 to 79 years and 80 years,the rate of CRT implantation was 5%vs 7%vs 4%,and 32%vs 36%vs 39%in patients with indicated unimplanted HF（P<0.05）3.The survival rate of narrow QRS was higher in 65 years of age than in LBBB or IVCD,（P<0.05）,no statistical significance;In 65～79 years old group,（P<0.05）,was statistically significant;In the 80-year age group,（P<0.05）,the difference was statistically significant.4.Compared with the patients who met the CRT indications but did not have CRT implantation,the benefit rate of patients with CRT implantation was more obvious and the mortality rate was lower（P<0.05）.Conclusion1.In HF patients,the prevalence of LBBB or IVCD is higher with age.2.In elderly HF patients,survival is lower with LBBB or IVCD.3.For patients with HF meeting CRT indications,patients with CRT implantation had higher benefits and lower mortality than patients without CRT implantation.