Influence of QRS duration on outcome of death or appropriate defibrillator therapy by strategy of left ventricular lead placement in cardiac resynchronization therapy recipients

Purpose Echocardiography-guided (EG) lead placement at the site of latest left ventricular (LV) mechanical activation improves outcome in patients receiving a cardiac resynchronization therapy (CRT) defibrillator (D). The purpose of this study is to examine whether a strategy of EG LV lead placement equally improves outcome in CRT recipients with wide (≥150 ms) versus intermediate (120–149 ms) QRS duration. Methods Patients treated with a CRT-D in the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region (STARTER) prospective, randomized trial (108 EG strategy and 75 routine strategy) were followed to the endpoint of death or first appropriate CRT-D therapy. Of the patients enrolled in STARTER, 115 had QRS ≥ 150 ms and 68 had 120