QRS analysis using wavelet transformation for the prediction of response to cardiac resynchronization therapy: a prospective pilot study

J Electrocardiol. 2014 Jan-Feb;47(1):59-65. doi: 10.1016/j.jelectrocard.2013.08.003. Epub 2013 Sep 10.

Abstract

Background: Wider QRS and left bundle branch block morphology are related to response to cardiac resynchronization therapy (CRT). A novel time-frequency analysis of the QRS complex may provide additional information in predicting response to CRT.

Methods: Signal-averaged electrocardiograms were prospectively recorded, before CRT, in orthogonal leads and QRS decomposition in three frequency bands was performed using the Morlet wavelet transformation.

Results: Thirty eight patients (age 65±10years, 31 males) were studied. CRT responders (n=28) had wider baseline QRS compared to non-responders and lower QRS energies in all frequency bands. The combination of QRS duration and mean energy in the high frequency band had the best predicting ability (AUC 0.833, 95%CI 0.705-0.962, p=0.002) followed by the maximum energy in the high frequency band (AUC 0.811, 95%CI 0.663-0.960, p=0.004).

Conclusions: Wavelet transformation of the QRS complex is useful in predicting response to CRT.

Keywords: Biventricular pacing; Heart failure; Morlet wavelet transform; QRS complex; Signal processing.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms*
  • Cardiac Resynchronization Therapy / methods*
  • Diagnosis, Computer-Assisted / methods*
  • Electrocardiography / methods*
  • Female
  • Heart Failure / diagnosis*
  • Heart Failure / prevention & control*
  • Humans
  • Male
  • Pilot Projects
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Treatment Outcome
  • Wavelet Analysis*