Paced QRS duration and XXXX amount: predictors of long-term outcome of right ventricular apical pacing.

@entity1 @entity296 @entity712 @entity910 @entity299
UNASSIGNED: Long-term right ventricular apical pacing (RVAP) is reportedly associated with @entity712 ( @entity712 ) development. However, the predictors of @entity910 ( @entity910 ) remained unclear. We retrospectively enrolled 234 @entity1 without structural @entity299 who underwent a permanent pacemaker implantation with RVAP between 1982 and 2004. RVAP-induced @entity712 was defined as left ventricular ejection fraction decrease >5  % with @entity712 symptom without other @entity712 development etiology. The QRS duration of a paced beat (pQRSd) and @entity296 score were analyzed from each @entity1 's 12-lead ECG. During a mean 15.6  years (range 3.3-30.0  years), 48 @entity1 (20.5  %) @entity1 developed RVAP-induced @entity712 . The @entity910 group @entity1 had a longer pQRSd (192.4      13.5 vs. 175.7      14.7  ms in non- @entity910 @entity1 , p  <  0.001) and a higher @entity296 score (5.2      1.9 vs. 2.7      1.9, respectively p  <  0.001). In multivariate Cox regression analysis, old age at implantation [Hazard ratio (HR) 1.62, 95  % confidential interval (CI) 1.22-2.16, p  =  0.001], a longer pQRSd (HR 1.54, 95  % CI 1.15-2.05, p  =  0.003), a higher @entity296 score (HR 1.23, 95  % CI 1.03-1.49, p  =  0.037), and a higher percentage of ventricular pacing (HR 1.31, 95  % CI 1.01-1.49, p  =  0.010) were independent predictors of @entity910 . Based on the results of the receiver-operating characteristic (ROC) curve, the pQRSd cutoff was 185  ms (AUC 0.79, sensitivity 66.7  %, specificity 76.3  %) and @entity296 score cutoff value was 4 (AUC 0.81, sensitivity 81.3  %, specificity 66.1  %). The pQRSd was positively correlated with scar score (r  =  0.70, p  <  0.001). pQRSd >= 185  ms and/or @entity296 score >= 4 might be independent long-term prognostic markers of @entity910 .
