Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy
Khaled Ashraf Shoman1, Hayam Mohammed Eldamanhory2, Emad Effat Fakhry2
1Cardiology Department, Ain Shams University, B6 - Madinaty-New Cairo, Abbassya, Cairo, 19519, Egypt. Khaledshoman91@hotmail.com.
Insights
Cardiac resynchronization therapy (CRT) response is not significantly different between Strauss and non-Strauss ECG criteria. However, Strauss criteria predict better improvement in heart failure symptoms and echocardiographic measures.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is a standard heart failure treatment.
- 20-40% of CRT recipients do not respond based on current selection criteria.
- Predicting CRT response using baseline parameters and ECG morphology is crucial.
Purpose of the Study:
- Identify baseline parameters predicting CRT response.
- Evaluate the impact of ECG morphology on CRT outcomes.
- Assess Strauss ECG criteria as a predictor of CRT response.
Main Methods:
- Study included 67 patients undergoing CRT implantation.
- Patients classified by LBBB ECG morphology: Strauss (30) vs. non-Strauss (37).
- Assessed CRT response, NYHA class, EF, ESV, GLS, and GCS at 6-month follow-up.
Main Results:
- Overall CRT response rate was 75.8% (50 patients).
- No significant difference in overall response or mortality between Strauss and non-Strauss groups (P=0.463).
- Strauss group showed significant improvement in NYHA class, EF, ESV, GLS, and GCS.
Conclusions:
- No statistical significance in overall CRT response or mortality between Strauss and non-Strauss ECG criteria.
- Patients with Strauss ECG criteria demonstrated better improvement in heart failure symptoms (NYHA class) and echocardiographic parameters (EF, ESV, GLS, GCS).
Background:
Cardiac resynchronization therapy (CRT) is a standard treatment in patients with heart failure; however, approximately 20-40% of recipients of (CRT) do not respond to it based on the current patients' selection criteria. The purpose of this study was to identify the baseline parameters that predict the CRT response and how the ECG morphology can affect the outcome. The study aimed to evaluate the Strauss ECG criteria as a predictor of response in patients undergoing cardiac resynchronization therapy.
Results:
Out of 70 patients, 3 patients missed the 6-month follow-up after CRT implantation, so the study enrolled 67 patients that have been classified according to ECG morphology of LBBB to 37 patients with non-Strauss ECG criteria-one of whom died after 4 months-and 30 patients with Strauss ECG criteria. The number of responders in the study was 50 patients with percentage 75.8%; 52% of CRT responder (26 patients) had non-Strauss ECG criteria, while 48% of CRT responders (24 patients) had Strauss ECG criteria with P value = 0.463. While there was no statistical significance of overall CRT response nor 6-month hospitalization and mortality between patients of Strauss and non-Strauss ECG criteria, there was a significant improvement in NYHA class, EF assessed by biplane Simpson's, end-systolic volume, global longitudinal strain and global circumferential strain by speckle tracking echocardiography in patients with Strauss ECG criteria of LBBB.
Conclusions:
There is no statistical significance in overall CRT response nor the 6-month hospitalization and mortality after 6 months of follow-up between patients with Strauss and non-Strauss ECG criteria of LBBB; however, patients with Strauss ECG criteria have better improvement in NYHA class, echocardiographic parameters such as EF and ESV and speckle tracking parameters (GLS and GCS).
More Related Videos
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
08:28Methods for ECG Evaluation of Indicators of Cardiac Risk, and Susceptibility to Aconitine-induced Arrhythmias in Rats Following Status Epilepticus
Published on: April 5, 2011
Related Concept Videos
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:24ECG Interpretation of Rhythms
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:30Dysrhythmias V: Evaluating Dysrhythmias
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...