QRS analysis using wavelet transformation for the prediction of response to cardiac resynchronization therapy: a prospective pilot study.

Abstract Background Wider QRS and left bundle branch block morphology are related to response to cardiac resynchronization therapy (CRT). A novel time-frequency analysis of the QRS complex may provide additional information in predicting response to CRT. Methods Signal-averaged electrocardiograms were prospectively recorded, before CRT, in orthogonal leads and QRS decomposition in three frequency bands was performed using the Morlet wavelet transformation. Results Thirty eight patients (age 65 ± 10 years, 31 males) were studied. CRT responders (n = 28) had wider baseline QRS compared to non-responders and lower QRS energies in all frequency bands. The combination of QRS duration and mean energy in the high frequency band had the best predicting ability (AUC 0.833, 95%CI 0.705-0.962, p = 0.002) followed by the maximum energy in the high frequency band (AUC 0.811, 95%CI 0.663-0.960, p = 0.004). Conclusions Wavelet transformation of the QRS complex is useful in predicting response to CRT.