Prevalence of Prolonged QRS Duration and Associated Factors among Heart Failure Patients in a Tertiary Healthcare Facility in Bayelsa State

Abstract

Niger Delta Journal of Medical Sciences Background: Prolonged QRS duration, low ejection fraction and low NYHA class are all independent poor prognostic indices in patients with heart failure. We assessed the prevalence of prolonged QRS duration and it's relationship with ejection fraction and NYHA class, among patients with heart failure at Niger Delta University Teaching Hospital, Okolobiri, Nigeria. Methods: Eighty three patients diagnosed with heart failure were recruited consecutively. NYHA class was determined at presentation. Electrocardiography and echocardiography were done to determine the QRS duration and ejection fraction respectively. Results: The prevalence of prolonged QRS was 33.7%. Most of the participants had QRS duration less than 120ms (66.3%), were classified as NYHA class 4 (48.2%) and had a diagnosis of hypertensive heart disease (57.8%). Sixty two patients (74.7%) had ejection fraction <45%.2 Ejection fraction showed a statistically significant relationship with prolonged QRS duration (X = 10.55; p – 0.001). Other factors such as age, sex, NYHA classification, BMI and blood pressure were not significantly related to prolonged QRS duration in this population. Conclusion: Over a third of patients in heart failure had QRS prolongation and there was a significant relationship between prolonged QRS duration and systolic dysfunction. Given these findings, appropriate screening of patients with heart failure is suggested to detect QRS prolongation and other ECG abnormalities, in order to adequately intervene and reduce risks of cardiovascular mortality.

KEYWORDS: Heart failure, QRS duration, Ejection fraction, NYHA class, Relationship