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October 22 2008

QRS Duration in Patients Hospitalized for Worsening Heart Failure

JAMA. 2008;300(16):1879-1881. doi:10.1001/jama.2008.504

To the Editor: The post hoc analysis of the EVEREST study by Dr Wang and colleagues1 demonstrated the adverse outcomes associated with prolonged QRS duration in patients hospitalized with decompensated heart failure. We have several observations regarding their findings.

The authors reported a prolonged QRS duration in 45% of their patients. They defined baseline QRS duration using ECG at the time of admission and then assessed QRS duration variability during the course of hospitalization. No data were provided on the QRS duration before and after hospitalization. Based on their findings, the authors suggest that a prolonged QRS duration may be a potential target for intervention (ie, cardiac resynchronization therapy) during hospitalization for decompensated heart failure.