目的：探讨碎裂QRS波( fQRS)对心脏再同步治疗( CRT)无反应的预测价值。方法选择150例患者,按心电图是否有fQRS分为fQRS组和无fQRS组。 CRT术前及术后6个月行纽约心功能分级,心电图和超声心动图检查。以术后6个月时心功能分级改善Ⅰ级以上或左室射血分数( LVEF)增加≥5%作为CRT有反应的标准,未达到该标准或患者心源性死亡定义为CRT无反应。用单因素和多因素Logistic回归分析fQRS对CRT无反应的预测价值。结果① fQRS组较无 fQRS 组 CRT 无反应发生率高(52．6% vs 18．7%,P<0．01)。②单因素及多因素Logistic回归分析均提示fQRS是CRT无反应的独立危险因素。结论 fQRS对CRT无反应有一定的预测价值。%Objective To explore the value of fragmented QRS( fQRS) in predicting the incidence of nonresponse to cardiac resynchronization therapy( CRT) . Methods One hundred and fifty patients were enrolled in this study. Study populations were divided into fQRS group and non-fQRS group according to the existence of fQRS on electro-cardiography ( ECG) . Before CRT implantation as well as 6 months after implantation,New York Heart Association ( NYHA) class, ECG and echocardiography were evaluated. Response to CRT was defined as improvement of at least one NYHA class or improvement of left ventricular ejection fraction ( LVEF) ≥5% 6 months after implana-tion. Patients were defined as nonresponders if they did not reach the prespecified standard or died of cardiac cau-ses. The univariate and multivariate Logistic regression analysis was performed to evaluate the predictive value of fQRS on nonresponse to CRT. Results ①Patients in fQRS group had a higher chance of nonresponse to CRT than in non-fQRS group (52. 6% vs 18. 7% P<0. 01). ②Both univariate and multivariate Logistic regression analysis showed that fQRS was an independent predictor of nonresponse to CRT. Conclusion fQRS is valuable in predic-ting the incidence of nonresponse to CRT.
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