On a Possible Mechanistic Association of QRS Duration and Atrial Fibrillation Reply

• Authors: Mikhael El Chami, Emory University
• Journal Title: Clinical Cardiology
• Volume: Volume 34, Number 3
• Publisher: Wiley Open Access: Various Creative Commons Licenses | 2011-03-01, Pages E13-E13
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1002/clc.20797
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology

Abstract

Author reply: We would like to thank Dr. Madias for his interest in our article.1 This article suggests that QRS‐complex duration (QRSd) is associated with atrial fibrillation (AF) independent of several different indicators of heart‐failure severity, comorbid conditions, and medications known to reduce AF incidence. Hence came our conclusion: “In this large cohort of patients, QRSd was strongly associated with AF and therefore may predict the occurrence of this arrhythmia in patients with LV (left ventricular) dysfunction.” We agree with Dr. Madias that prediction of AF requires observational studies with long‐term follow‐up and monitoring for AF development and/or QRS widening. The major limitation of our manuscript is the retrospective nature of the study, which was acknowledged in the “Limitations” section of the article. We believe, however, that this study, like any other good retrospective study, produces more questions than answers. These questions will need to be addressed in a prospective manner. Hence, the conclusion that QRSd may predict the occurrence of AF in patients with LV dysfunction needs to be verified prospectively and longitudinally, as Dr. Madias suggested.