Predictive value of <i>QRS</i> complex duration in patients with chronic heart failure and atrial fibrillation: retrospective study

Abstract

Aim. To study of the features of the clinical course and prognosis in patients with chronic heart failure with low ejection fraction (HFrEF) and atrial fibrillation (AF) depending on the width of the QRS complex. Materials and methods. We studied the case histories of 514 patients (aged 60.213.84 years, 78% men) with HFrEF, hospitalized at the Chazov National Medical Research Center of Cardiology (Moscow) for the period from Jan 1, 2017 to Dec 31, 2018. Patients were divided into 2 groups depending on the duration of the QRS complex. Results. Clinical and statistical retrospective analysis of the medical histories of patients with HFrEF, depending on the QRS duration, showed the predominance of patients with a QRS complex size of less than 130 ms (60.7%). In HFrEF, the expansion of the QRS complex is accompanied by an increase in the rate of readmission in patients with sinus rhythm (p=0.004). In patients with AF, the rehospitalization rate is significantly higher than in sinus rhythm and does not depend on the QRS duration (p=0.001). The incidence of unfavorable outcomes increases in connection with the addition of AF, which is most likely a more significant risk factor than QRS width. Conclusion. These results highlight that patients with AF and a narrow QRS complex have the same poor prognosis as those with a wide QRS complex and require the close attention of cardiologists.