The Open Cardiovascular and Thoracic Surgery Journal

2009, 2 : 18-20
Published online 2009 April 30. DOI: 10.2174/1876533500902010018
Publisher ID: TOCTSJ-2-18

Fragmented QRS and Ventricular Dyssynchrony in a Patient Treated with Cardiac Resynchronization Therapy

Stelios Paraskevaidis , Georgios Giannakoulas , Kostas Polymeropoulos , Vassilios Vassilikos , Emmanouela Dalamanga , Haralambos Dalamanga , Stavros Hadjimiltiades and Georgios E. Parcharidis
Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece.

ABSTRACT

Cardiac resynchronization is an established treatment modality in patients with heart failure NYHA class III-IV on optimal medical treatment, QRS duration of at least 120-130 ms and ejection fraction <35%. Nevertheless, a proportion of patients, up to 20-30%, are considered non-responders as they are not improved by cardiac resynchronization therapy (CRT). This report describes a 63-year-old patient with ischemic cardiomyopathy, severe mitral regurgitation, and fragmented QRS complex in several leads. The patient had LV dyssynchrony identified by echocardiographic tissue Doppler imaging. A biventricular pacemaker was implanted successfully, and resulted in improvement in LV dyssynchrony, LV dimensions, mitral regurgitation and symptoms. Fragmented QRS complex as a marker of ventricular dyssynchrony may play a role in identifying patients who may benefit from cardiac resynchronization therapy.