Ayhan KÜP, Mehmet ÇELİK, Şeyhmus KÜLAHÇIOĞLU, Abdulkadi USLU, Mert EVLICE, Mehmet Muhsin TÜRKMEN, Ramazan KARGIN

Non-İskemik Dilate Kardiyomyopati Hastalarında Fragmante QRS’in Bi-ventrikuler Pacemaker Tedavisine Etkisi

Giriş: Kardiyak resenkronizasyon tedavisi (KRT) kalp yetmezliğinde etkili bir tedavidir ancak; uygun hastaları belirlemek zordur. Fragmente QRS (fQRS) kompleksi, miyokardial skarı gösteren iletim anormalliğidir. Bu çalışma, non-iskemik dilate kardiyomiyopatili (NKMP) hastalarda fQRS’in KRT yanıtına etkisini değerlendirmek için yapılmıştır Yöntemler: Çalışmaya prospektif olarak 56 hasta alındı. Elektrokardiyografide (EKG) 32 hastada fQRS (%57.1) mevcuttu. KRT tedavisine uygun olmayan hastalar çalışma dışı bırakıldı. Klinik durum, EKG ve ekokardiyografik parametreler kullanılarak KRT öncesi ve sonrası (1 yıl) iki grup (fQRS ve fQRS yok) arasındaki farklılık değerlendirildi. Sürekli parametreler Paired Samples T-testi ile karşılaştırıldı. Bulgular: Takip döneminde; fQRS olan ve olmayan grup arasında QRS süresi (p=0.46, p=0.61) ve NYHA fonksiyonel sınıfı açısından (p=0.29, p=0.57) KRT öncesi ve sonrası istatistiksel olarak anlamlı değildi. Ayrıca sol ventrikül ejeksiyon fraksiyonundaki değişim açısından istatistiksel anlamlılık saptanmadı (p=0.12). Sonuç: NKMP'li hastalarda fQRS varlığı KRT yanıtı ile ilişkili değildir.

Anahtar Kelimeler:

Kardiyak Resenkronizasyon Tedavisi, Elektrokardiyografi, Kalp Yetmezliği, Fragmante QRS

The Evaluation Of The Response To Cardiac Resynchronization Therapy In Patients With Dilated Cardiomyopathy By Using Fragmented QRS

Introduction: Cardiac resynchronization therapy (CRT) is an effective treatment in heart failure however; identifying the suitable patients is difficult. Fragmented QRS (fQRS) complex is a myocardial conduction abnormality that indicates myocardial scar. This study was conducted to find out the response of non-ischemic dilated cardiomyopathy (NCMP) to CRT by using fQRS. Methods: 56 patients were enrolled. 32 patients had fQRS (57.1%) and 24 had no fQRS (46.9%) on electrocardiography (ECG). All patients were suitable for CRT treatment. The two groups (fQRS and no fQRS) were evaluated before and after (1 year) CRT by using clinical status, ECG, and echocardiographic parameters. Continuous parameters were compared with Paired Samples T-test. Results: During the follow-up period; comparison of QRS (p=0.46, p=0.61), and NYHA class (p=0.29, p=0.57) were not statistically significant before and after CRT, respectively (fQRS and no fQRS). In addition, the change in left ventricular ejection fraction is not statistically significant (p=0.12). Conclusion: fQRS presence is not associated with CRT response in patients with NCMP.

Keywords:

Cardiac Resynchronization Therapy, Electrocardiography, Heart Failure, Fragmented QRS Cardiac Resynchronization Therapy, Electrocardiography, Heart Failure, Fragmented QRS,

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