Usefulness of prolonged QRS duration to identify high-risk ischemic cardiomyopathy patients with syncope and inducible ventricular tachycardia

We evaluated 61 consecutive patients who had coronary artery disease, decreased left ventricular function, and syncope and underwent implantation of a cardioverter-defibrillator because sustained ventricular tachycardia was inducible at electrophysiologic testing. During a follow-up of 3.0 ± 1.8 years, 23 patients (38%) developed ventricular tachycardia. Prolonged QRS duration (≥120 ms) was the only significant predictor of arrhythmia. The 1- and 2-year rates without ventricular arrhythmia were 82% and 77%, respectively, in patients whose QRS duration was <120 ms. In contrast, 1- and 2-year rates without ventricular arrhythmia were only 64% and 51%, respectively, in patients whose QRS duration was ≥120 ms (risk ratio 3.7, 95% confidence interval 1.4 to 9.8, p = 0.0092).