Should the QRS Threshold for CRT Be Lower in Women Than in Men?

In a patient-level meta-analysis of three randomized trials, women — but not men — with QRS durations of 130–149 milliseconds derived a significant benefit from CRT.

In clinical trials of cardiac resynchronization therapy (CRT) for patients with systolic heart failure (HF) and ventricular dyssynchrony, the benefits of CRT were clearer for left bundle branch block (LBBB) than for other forms of intraventricular conduction delay and greater with increasing QRS duration. Thus, the strongest guideline recommendations for CRT use are reserved for patients with symptomatic systolic HF, LBBB, and QRS durations of ≥150 milliseconds. In most studies, women have tended to derive greater benefits than men; however, whether this difference is consistent across the spectrum of QRS duration is unknown. To investigate, FDA researchers analyzed patient-level data from three randomized, controlled trials comparing CRT p…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Should the QRS Threshold for CRT Be Lower in Women Than in Men?

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Reviewing Author