Selvester QRS score predicts improvement of LVEF in atrial fibrillation patients with systolic heart failure

Yoshihiro Nomura, Masahide Harada, Yuji Motoike, Asuka Nishimura, Masayuki Koshikawa, Takehiro Ito, Yoshihiro Sobue, Fumihiko Kitagawa, Eiichi Watanabe, Yukio Ozaki, Hideo Izawa

Research output: Contribution to journalArticlepeer-review


Background: Left-ventricular systolic dysfunction (LVSD) comorbid with atrial fibrillation is reversible, but recovery is limited in a subset of patients. The Selvester QRS (S-QRS) score is an electrocardiogram-based assessment that reportedly reflects myocardial scar/damage. We evaluated the predictability of S-QRS score for the recovery of left-ventricular ejection fraction (LVEF) in persistent AF (PeAF) patients with LVSD undergoing catheter ablation (CA). Method: CA was performed in 51 PeAF patients with reduced LVEF (<40%); S-QRS scores were measured after restoration of sinus rhythm. LVEF was re-evaluated at one year after CA; LVEF recovery was related to the S-QRS score. Results: The median [interquartile range] S-QRS score was 1 point [0–2]. LVEF increased from 32% [28–37] at baseline to 56% [49–57] at 1 year after CA. Thirty-seven patients achieved normalization of LVEF (≥50%, Group A); 14 patients did not (Group B). Group A had significantly lower S-QRS scores than Group B (0 point [0–2] vs. 2 points [2–3], p <.05). In univariate/multivariate analyses, S-QRS score was an independent predictor of LVEF normalization. In the receiver operating characteristic curve, the cut-off value of S-QRS score was 2 points for prediction of the LVEF normalization (AUC = 0.79). Patients with low S-QRS score (<2 points) had greater LVEF improvement than those with high S-QRS score (≥2 points, ΔLVEF: 23% [17–28] vs. 17% [12–24], p <.05). Conclusion: S-QRS scoring noninvasively assesses the improvement of LVEF in PeAF patients with LVSD after CA. A high S-QRS score may indicate underlying myocardial scar/damage associated with unknown etiologies for LVSD other than PeAF.

Original languageEnglish
Pages (from-to)619-628
Number of pages10
JournalPACE - Pacing and Clinical Electrophysiology
Issue number5
Publication statusPublished - 05-2022

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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