Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy

Khaled Ashraf Shoman; Hayam Mohammed Eldamanhory; Emad Effat Fakhry; Haitham Abdelfatah Badran

doi:10.1186/s43044-022-00308-3

Role of Strauss ECG criteria as predictor of response in patients undergoing cardiac resynchronization therapy

Egypt Heart J. 2022 Sep 30;74(1):69. doi: 10.1186/s43044-022-00308-3.

Authors

Khaled Ashraf Shoman¹, Hayam Mohammed Eldamanhory², Emad Effat Fakhry², Haitham Abdelfatah Badran²

Affiliations

¹ Cardiology Department, Ain Shams University, B6 - Madinaty-New Cairo, Abbassya, Cairo, 19519, Egypt. Khaledshoman91@hotmail.com.
² Cardiology Department, Ain Shams University, B6 - Madinaty-New Cairo, Abbassya, Cairo, 19519, Egypt.

Abstract

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).

Keywords: Cardiac resynchronization therapy; Ejection fraction; Electrocardiogram; End-systolic volume; Global circumferential strain; Global longitudinal strain; Left bundle branch block; New York heart association.