{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T02:32:25Z","timestamp":1769913145693,"version":"3.49.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,11,22]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>A prolonged PR interval is common among cardiac resynchronization therapy (CRT) candidates; however, the association between PR interval and outcomes is unclear, and the data are conflicting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We conducted inverse probability weighted analyses of 26\u2009451 CRT-eligible (ejection fraction \u226435, QRS \u2265120 ms) patients from the National Cardiovascular Data Registry ICD Registry to assess the association between a prolonged PR interval (\u2265230 ms), receipt of CRT with defibrillator (CRT-D) versus implantable cardioverter defibrillator (ICD), and outcomes. We first tested the association between a prolonged PR interval and outcomes among patients stratified by device type. Next, we performed a comparative effectiveness analysis of CRT-D versus ICD among patients when stratified by PR interval. Using Medicare claims data, we followed up with patients up to 5 years for incident heart failure hospitalization or death.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Patients with a PR\u2265230 ms (15%; n=4035) were older and had more comorbidities, including coronary artery disease, atrial arrhythmias, diabetes mellitus, and chronic kidney disease. After risk adjustment, a PR\u2265230 ms (versus PR&lt;230 ms) was associated with increased risk of heart failure hospitalization or death among CRT-D (hazard ratio, 1.23; 95% confidence interval, 1.14\u20131.31;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but not ICD recipients (hazard ratio, 1.08; 95% confidence interval, 0.97\u20131.20;\n              <jats:italic>P<\/jats:italic>\n              =0.17) (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.043). CRT-D (versus ICD) was associated with lower rates of heart failure hospitalization or death among patients with PR&lt;230 ms (hazard ratio, 0.79; 95% confidence interval, 0.73\u20130.85;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but not PR\u2265230 ms (hazard ratio, 1.01; 95% confidence interval, 0.87\u20131.17;\n              <jats:italic>P<\/jats:italic>\n              =0.90) (\n              <jats:italic>P<\/jats:italic>\n              <jats:sub>interaction<\/jats:sub>\n              =0.0025).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>A PR\u2265230 ms is associated with increased rates of heart failure hospitalization or death among CRT-D patients. The real-world comparative effectiveness of CRT-D (versus ICD) is significantly less among patients with a PR\u2265230 ms in comparison with patients with a PR&lt;230 ms.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.116.022913","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T03:33:58Z","timestamp":1476934438000},"page":"1617-1628","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Association Between a Prolonged PR Interval and Outcomes of Cardiac Resynchronization Therapy"],"prefix":"10.1161","volume":"134","author":[{"given":"Daniel J.","family":"Friedman","sequence":"first","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haikun","family":"Bao","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica S.","family":"Spatz","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeptha P.","family":"Curtis","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Daubert","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sana M.","family":"Al-Khatib","sequence":"additional","affiliation":[{"name":"From Division of Cardiology, Duke University Hospital, Durham, NC (D.J.F., J.P.D., S.M.A.-K.); Duke Clinical Research Institute, Durham, NC (D.J.F., S.M.A.-K.); and Yale University School of Medicine, New Haven, CT (H.B., E.S.S., J.P.C.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.03.059"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.960898"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.8641"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318276ce9b"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.001299"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.07.038"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-015-9999-y"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfp074"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.06.016"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.06.024"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2014.07.024"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1992.tb02996.x"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)90170-2"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.07.015"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.01.035"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.020"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.04.002"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.09.097"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.96867"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-6-199903160-00002"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.02.020"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1054\/jcaf.2000.20841"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-9842(01)00176-3"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.04.013"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.02.034"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.992552"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2012.07.009"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2015.07.013"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.116.022913","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:37:10Z","timestamp":1715582230000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.116.022913"}},"subtitle":["A Report From the National Cardiovascular Data Registry"],"short-title":[],"issued":{"date-parts":[[2016,11,22]]},"references-count":30,"journal-issue":{"issue":"21","published-print":{"date-parts":[[2016,11,22]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.116.022913"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.116.022913","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,22]]},"assertion":[{"value":"2016-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}