Evaluating the Association between Cardiac Memory T-wave and Cardiac
Resynchronization Therapy Response in Patients with Heart Failure
Abstract
Background and Aims: We evaluated whether cardiac memory T-wave (CMT) is
associated with reverse remodeling of left ventricular as an indicator
of response to cardiac resynchronization therapy (CRT). Methods and
Results: CMT was defined as a negative T-wave in right and mid
precordial leads with negative wide QRS complexes before CRT
implantation. We studied 100 patients (50 consecutive patients with CMT
and 50 consecutive patients without CMT) who underwent CRT. Patients’
resting 12-lead ECGs before and immediately after implantation of CRT
were analyzed by an electrophysiologist to confirm the presence or
absence of CMT. Response to CRT was defined as at least one NYHA class
decrease and ≥15% decrease in left ventricular end-systolic volume
(LVESV) 6 months after CRT implantation. Patients with and without CMT
were compared in terms of response to CRT. The number of patients with
CMT who responded to CRT was higher in comparison to the patients
without CMT (64% vs, 36%, p<0.001). In the multivariate
regression model, CMT remained associated with response to CRT after
adjusting for baseline characteristics [odds ratio (OR) (95% CI) 4.79
(2.01–11.43), P < 0.001]. Conclusion: There is a strong
relationship between the presence of CMT as a marker of reversed
ventricular remodeling and the response to CRT. Moreover, since CMT
occurs just after CRT implantation, it can be considered as an early
valuable predictor of response to CRT. Consequently, the presence of CMT
can be administered as a measure of response to CRT.