{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:50:10Z","timestamp":1784195410012,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,12,19]],"date-time":"2016-12-19T00:00:00Z","timestamp":1482105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Medtronic, Inc., Bakken Research Center (BRC), Maastricht, The Netherlands"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Paced QRS Area Predicts CRT Response<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system. Maximum QRS vector amplitudes (X<jats:sub>Ampl<\/jats:sub>, Y<jats:sub>Ampl<\/jats:sub>, Z<jats:sub>Ampl<\/jats:sub>, and 3D<jats:sub>Amp<\/jats:sub>) and QRS areas (X<jats:sub>Area<\/jats:sub>, Y<jats:sub>Area<\/jats:sub>, Z<jats:sub>Area<\/jats:sub>, and 3D<jats:sub>Area<\/jats:sub>) in the orthogonal leads (X, Y, and Z) and in 3\u2010dimensional projection were measured. Volume of the 3D vector loop and global QRS duration (QRSD) on the surface electrocardiogram were assessed. Differences (\u0394) in VCG parameters between BV paced and LBBB QRS complexes were calculated. An increase of 10% in dP\/dt max was considered as AHR. LBBB conduction is characterized by a large Z<jats:sub>Area<\/jats:sub> (109 \u03bcVs, interquartile range [IQR]:75;135), significantly larger than X<jats:sub>Area<\/jats:sub> (22 \u03bcVs, IQR:10;57) and Y<jats:sub>Area<\/jats:sub> (44 \u03bcVs, IQR:32;62, P &lt; 0.001). Overall, QRS duration, amplitudes, and areas decrease significantly with BV pacing (P &lt; 0.001). Of all VCG parameters, 3D<jats:sub>Ampl<\/jats:sub>, \u03943D<jats:sub>Ampl<\/jats:sub>, Z<jats:sub>Area,<\/jats:sub> \u0394Z<jats:sub>Area<\/jats:sub>, \u03943D<jats:sub>Area<\/jats:sub>, and \u0394QRSD differentiate AHR response from nonresponse (P &lt; 0.05). \u0394Z<jats:sub>Area<\/jats:sub> predicted best positive AHR (area under the curve = 0.813) and outperformed any other VCG parameter or QRSD measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Of all VCG parameters, reduction in QRS area, calculated in Frank's Z lead, predicts acute hemodynamic response best. This method might\u00a0be an easy, noninvasive tool to guide CRT implantation and optimization.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13132","type":"journal-article","created":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T07:02:57Z","timestamp":1480057377000},"page":"192-200","source":"Crossref","is-referenced-by-count":25,"title":["Biventricular Paced QRS Area Predicts Acute Hemodynamic CRT Response Better Than QRS Duration or QRS Amplitudes"],"prefix":"10.1111","volume":"28","author":[{"given":"JAN","family":"DE POOTER","sequence":"first","affiliation":[{"name":"Ghent University Hospital Heart Center  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MILAD","family":"EL HADDAD","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MARC","family":"DE BUYZERE","sequence":"additional","affiliation":[{"name":"Ghent University Hospital 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Second Department of Coronary Artery Disease Institute of Cardiology  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ADAM","family":"SOKAL","sequence":"additional","affiliation":[{"name":"Department of Cardiology Congenital Heart Diseases and Electrotherapy Silesian Center of Heart Disease  Zabrze Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DARREL P.","family":"FRANCIS","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Imperial College Healthcare NHS Trust  London England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LUC","family":"JORDAENS","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ROLAND X.","family":"STROOBANDT","sequence":"additional","affiliation":[{"name":"Ghent University Hospital Heart Center  Ghent 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