{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:12:35Z","timestamp":1787069555979,"version":"build-2736575974"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2014,9,8]],"date-time":"2014-09-08T00:00:00Z","timestamp":1410134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2013-23897-104604-23"],"award-info":[{"award-number":["2013-23897-104604-23"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Heart Lung Foundation","award":["20080409"],"award-info":[{"award-number":["20080409"]}]},{"name":"Swedish Heart Lung Foundation","award":["20100419"],"award-info":[{"award-number":["20100419"]}]},{"name":"Swedish Heart Lung Foundation","award":["20080498"],"award-info":[{"award-number":["20080498"]}]},{"name":"Swedish Heart Lung Foundation","award":["20110406"],"award-info":[{"award-number":["20110406"]}]},{"name":"Swedish Heart Lung Foundation","award":["20090870"],"award-info":[{"award-number":["20090870"]}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["20090556"],"award-info":[{"award-number":["20090556"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["20110120"],"award-info":[{"award-number":["20110120"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["20090376"],"award-info":[{"award-number":["20090376"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004348","name":"Stockholm County Council","doi-asserted-by":"publisher","award":["20110610"],"award-info":[{"award-number":["20110610"]}],"id":[{"id":"10.13039\/501100004348","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Age is not a contraindication to cardiac resynchronization therapy (CRT), but the prevalence and prognostic impact of QRS prolongation with intraventricular conduction delay (IVCD) and left bundle branch block (LBBB), as well as CRT utilization, may differ with age. We tested the hypotheses that in the elderly: (i) IVCD and LBBB are more prevalent, (ii) IVCD and LBBB are more harmful, and (iii) CRT is underutilized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We studied 14\u2009713 patients with ejection fraction \u226439% in the Swedish Heart Failure Registry and divided into age groups \u226465\u2009years, 66\u201380\u2009years and &amp;gt;80\u2009years. Among 13\u2009782 patients without CRT, IVCD was present in the three age groups in 11% vs. 15% vs. 19% and LBBB was present in 20% vs. 27% vs. 28%, respectively, (P\u2009&amp;lt;\u20090.001). The multivariable hazard ratio (HR) for all-cause mortality over a median (interquartile range) follow-up of 29 (12\u201353) months for IVCD vs. narrow QRS was 1.31 (1.06\u20131.63, P\u2009=\u20090.013) in the \u226465\u2009year group, 1.32 (1.17\u20131.47, P\u2009&amp;lt;\u20090.001) in the 66\u201380\u2009year group, and 1.26 (1.21\u20131.41, p\u2009&amp;lt;\u20090.001) in the &amp;gt;80\u2009year group. For LBBB vs. narrow QRS it was 1.29 (1.07\u20131.56, P\u2009=\u20090.009), 1.17 (1.06\u20131.30, P\u2009=\u20090.002), and 1.10 (0.99\u20131.22, P\u2009=\u20090.091), respectively. The adjusted P for interaction between age and QRS morphology was 0.664. In the three age groups, CRT was present in 6% vs. 8% vs. 4% and absent but with indication in 23% vs. 32% vs. 37%, respectively (P\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both IVCD and LBBB were more common with increasing age and were similarly strong independent predictors of mortality and in all ages. The underutilization of CRT was worse with increasing age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.162","type":"journal-article","created":{"date-parts":[[2014,9,8]],"date-time":"2014-09-08T11:21:54Z","timestamp":1410175314000},"page":"1073-1081","source":"Crossref","is-referenced-by-count":56,"title":["Age, Prognostic Impact of QRS Prolongation and Left Bundle Branch Block, and Utilization of Cardiac Resynchronization Therapy: Findings from 14\u2009713 Patients in the Swedish Heart Failure Registry"],"prefix":"10.1093","volume":"16","author":[{"given":"Lars H.","family":"Lund","sequence":"first","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Medicine, Unit of Cardiology , N305, 17176, Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Benson","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Clinical Science and Education, S\u00f6dersjukhuset , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"St\u00e5hlberg","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Medicine, Unit of Cardiology , N305, 17176, Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieder","family":"Braunschweig","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Medicine, Unit of Cardiology , N305, 17176, Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Edner","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Medicine, Unit of Cardiology , N305, 17176, Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Dahlstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Department of Medicine and Health Sciences, Link\u00f6ping University , Link\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Linde","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Department of Medicine , Stockholm ,","place":["Sweden"]},{"name":"Karolinska University Hospital, Department of Medicine, Unit of Cardiology , N305, 17176, Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,9,8]]},"reference":[{"key":"2026011921125244100_ejhf162-bib-0001","doi-asserted-by":"crossref","first-page":"3547","DOI":"10.1093\/eurheartj\/eht290","article-title":"An individual patient meta-analysis of five randomized trials assessing the effects of cardiac resynchronization therapy on morbidity and mortality in patients with symptomatic heart failure","volume":"34","author":"Cleland","year":"2013","journal-title":"Eur Heart J"},{"key":"2026011921125244100_ejhf162-bib-0002","doi-asserted-by":"crossref","first-page":"401","DOI":"10.7326\/0003-4819-154-6-201103150-00313","article-title":"Meta-analysis: cardiac resynchronization therapy for patients with less symptomatic heart failure","volume":"154","author":"Al-Majed","year":"2011","journal-title":"Ann Intern Med"},{"key":"2026011921125244100_ejhf162-bib-0003","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1093\/eurheartj\/eht150","article-title":"2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). 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