{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:44:18Z","timestamp":1758703458474,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"am","delay-in-days":348,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T00:00:00Z","timestamp":1588896000000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["5T32HL069749"],"award-info":[{"award-number":["5T32HL069749"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A low electrocardiogram (ECG) lead one ratio (LOR) of the maximum positive\/negative QRS amplitudes is associated with lower left ventricular ejection fraction (LVEF) and worse outcomes in left bundle branch block (LBBB); however, the impact of LOR on cardiac resynchronization therapy (CRT) outcomes is unknown. We compared clinical outcomes and echocardiographic changes after CRT implantation by LOR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive CRT\u2010defibrillator recipients with LBBB implanted between 2006 and 2015 at Duke University Medical Center were included (N\u00a0=\u00a0496). Time to heart transplant, left ventricular assist device (LVAD) implantation, or death was compared among patients with LOR\u00a0&lt;12\u00a0vs \u226512 using Cox\u2010proportional hazard models. Changes in LVEF and LV volumes after CRT were compared by LOR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline ECG LOR\u00a0&lt;12 was associated with an adjusted hazard ratio (HR) of 1.69 (95% CI: 1.12\u20102.40, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01) for heart transplant, LVAD, or death. Patients with LOR\u00a0&lt;12 had less reduction of LV end diastolic volume (\u0394LVEDV \u22124 \u00b1 21\u00a0vs \u221213 \u00b1 23%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04) and LV end systolic volume (\u0394LVESV \u22129 \u00b1 27\u00a0vs \u221222 \u00b1 26%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) after CRT. In patients with QRS duration (QRSd) \u2265150\u00a0ms, LOR\u00a0&lt;12 was associated with an adjusted HR of 2.01 (95% CI 1.21\u20103.35, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.008) for heart transplant, LVAD, or death, compared with LOR \u226512.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Baseline ECG LOR\u00a0&lt;12 portends worse outcomes after CRT implantation in patients with LBBB, specifically among those with QRSd \u2265150\u00a0ms. This ECG ratio may identify patients with a class I indication for CRT implantation at high risk for poor postimplantation outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.13916","type":"journal-article","created":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T11:24:44Z","timestamp":1586863484000},"page":"503-510","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lead one ratio in left bundle branch block predicts poor cardiac resynchronization therapy response"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-582X","authenticated-orcid":false,"given":"Zak","family":"Loring","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Medicine Duke University Medical Center  Durham North Carolina"},{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Duke University Medical Center  Durham North Carolina"},{"name":"Duke Clinical Research Institute  Durham North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasper","family":"Emerek","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Medicine Duke University Medical Center  Durham North Carolina"},{"name":"Department of Clinical Medicine Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus","family":"Graff","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology Aalborg University  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steen M.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Biostatistics Aalborg University Hospital  Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjorn","family":"Wieslander","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology Karolinska Institute, and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Ugander","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology Karolinska Institute, and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"S\u00f8gaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aalborg University  Aalborg 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