Postoperative changes in QRS duration and long-term mortality after septal myectomy
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives: To evaluate whether change in QRS duration (ΔQRS), defined as postoperative QRS duration minus preoperative QRS duration, after septal myectomy for obstructive hypertrophic cardiomyopathy (oHCM) has prognostic significance for all-cause mortality. Methods: We performed a retrospective, single-center cohort study of patients with oHCM who underwent transaortic septal myectomy between July 23, 2009, and July 30, 2020, with available preoperative and early postoperative (days 4-7) electrocardiography (ECG) data. Patients with a preoperative or postoperative permanent pacemaker were excluded. The primary outcome was all-cause mortality. Multivariable Cox models were adjusted for age, sex, operative time, major concomitant surgery, and preoperative right bundle branch block. ECG analyses examined preoperative QRS duration, ΔQRS (postoperative minus preoperative QRS), and, in exploratory models, postoperative left bundle branch block (LBBB) and absolute postoperative QRS duration. Results: = .52). In exploratory comparison models, ΔQRS showed a stronger and more consistent association with mortality compared to postoperative LBBB or absolute postoperative QRS duration. Conclusions: ΔQRS following transaortic septal myectomy for oHCM was independently associated with all-cause mortality. In exploratory comparison models, ΔQRS showed a stronger and more consistent association with mortality compared to postoperative LBBB or absolute postoperative QRS duration. ΔQRS may represent a simple, clinically available marker to enhance postoperative risk stratification following septal myectomy for oHCM.
Source: JTCVS Open
Institutions: Brigham and Women's Hospital, Mayo Clinic
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,431
OpenAlex ID: W7165393088