Wang NC, Maggioni AP, Konstam MA, Zannad F, Krasa HB, Burnett JC, Grinfeld L, Swedberg K, Udelson JE, Cook T, Traver B, Zimmer C, Orlandi C, Gheorghiade M Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) Investigators. Significance of QRS complex duration in patients with heart failure. Left bundle-branch block also weakly predicted arrhythmic death ( P=0.04), but right bundle-branch block was not associated with increased mortality.
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Subjects with intraventricular conduction delay had increased all-cause mortality (RR 2.01 CI 1.52–2.66 P<0.001), increased cardiac mortality (RR 2.53 CI 1.64–3.90 P<0.001), and an elevated risk of arrhythmic death (RR 3.11 CI 1.74–5.54 P=0.001). Prolonged QRS duration predicted all-cause mortality (multivariate-adjusted relative risk 1.48 95% confidence interval 1.22–1.81 P<0.001), cardiac mortality (RR 1.94 CI 1.44–2.63 P<0.001), and sudden arrhythmic death (RR 2.14 CI 1.38–3.33 P=0.002). QRS duration ≥110 ms was present in 1.3% (n=147) and intraventricular conduction delay in 0.6% (n=67) of the subjects. Prolonged QRS duration was defined as QRS ≥110 ms and intraventricular conduction delay as QRS ≥110 ms, without the criteria of complete or incomplete bundle-branch block. Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. We evaluated the 12-lead ECGs of 10 899 Finnish middle-aged subjects from the general population (52% of whom were men mean age 44☘.5 years) between 19 and followed them for 30☑1 years. Customer Service and Ordering Information.About Circ: Arrhythmia and Electrophysiology.
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Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).