Selvester QRS score predicts improvement of LVEF in atrial fibrillation patients with systolic heart failure. Issue 5 (16th April 2022)

• Record Type: Journal Article
• Authors: Nomura, Yoshihiro; Harada, Masahide; Motoike, Yuji; Nishimura, Asuka; Koshikawa, Masayuki; Ito, Takehiro; Sobue, Yoshihiro; Kitagawa, Fumihiko; Watanabe, Eiichi; Ozaki, Yukio; Izawa, Hideo
• Is Part Of: Pacing and clinical electrophysiology. Volume 45:Issue 5(2022)
• Page Start: 619
• Page End: 628
• Publication Date: 2022-04-16
• Subjects: ablation -- atrial fibrillation -- congestive heart failure -- electrocardiogram -- Selvester QRS score; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.14498
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: Background: Left‐ventricular systolic dysfunction (LVSD) comorbid with atrial fibrillation is reversible, but recovery is limited in a subset of patients. The Selvester QRS (S‐QRS) score is an electrocardiogram‐based assessment that reportedly reflects myocardial scar/damage. We evaluated the predictability of S‐QRS score for the recovery of left‐ventricular ejection fraction (LVEF) in persistent AF (PeAF) patients with LVSD undergoing catheter ablation (CA). Method: CA was performed in 51 PeAF patients with reduced LVEF (<40%); S‐QRS scores were measured after restoration of sinus rhythm. LVEF was re‐evaluated at one year after CA; LVEF recovery was related to the S‐QRS score. Results: The median [interquartile range] S‐QRS score was 1 point [0–2]. LVEF increased from 32% [28–37] at baseline to 56% [49–57] at 1 year after CA. Thirty‐seven patients achieved normalization of LVEF (≥50%, Group A); 14 patients did not (Group B). Group A had significantly lower S‐QRS scores than Group B (0 point [0–2] vs. 2 points [2–3], p < .05). In univariate/multivariate analyses, S‐QRS score was an independent predictor of LVEF normalization. In the receiver operating characteristic curve, the cut‐off value of S‐QRS score was 2 points for prediction of the LVEF normalization (AUC = 0.79). Patients with low S‐QRS score (<2 points) had greater LVEF improvement than those with high S‐QRS score (≥2 points, ΔLVEF: 23% [17–28] vs. 17% [12–24], p < .05). Conclusion: S‐QRS scoring noninvasively assesses the improvement of LVEF in PeAF patients with LVSD after CA. A high S‐QRS score may indicate underlying myocardial scar/damage associated with unknown etiologies for LVSD other than PeAF.