Prognostic Value of ECG Findings in Patients With Decompensated Heart Failure

ECGs are recognized as a useful tool for improving the prognosis and management of patients with heart failure (HF). However, the relationship between ECG findings and clinically important outcomes remains unclear in patients with HF. This study aimed to describe ECG findings in patients with HF and their prognosis.

This cross-sectional study was conducted on a convenience sample of 50 hospitalized patients with decompensated HF at Shafa Hospital, Kerman University of Medical Sciences, over a 1-year period, from 2017 through 2018. All eligible patients who met the inclusion criteria of having a history of HF and being likely to be hospitalized in the cardiology unit were enrolled during the study period. Upon admission and before discharge, ECGs were performed, and the findings (QT interval, QRS duration, and PR interval) were compared. Three months after discharge, a follow-up was done concerning mortality. The Wilcoxon test and the Mann-Whitney U test were used to compare the ECG indices of the patients. SPSS, version 23, was utilized for data analysis.

More than half of the patients were diagnosed with severe HF (n=29, 58%). The length of hospital stay and history of admission were higher in patients with severe HF than in those with moderate HF (P<0.0001). Heart rate significantly decreased in patients with moderate and severe HF (P=0.001 and P=0.04, respectively). There was no significant difference between survivors and nonsurvivors regarding ECG changes.

Based on the present findings, widened QRS, prolonged PR interval, and increased heart rate were associated with poor outcomes. QRS duration, PR interval, and heart rate measured upon admission could be used to improve physicians’ clinical decisions.