Fragmentation of the QRS complex: the latest electrocardiographic craze?

Brohet, Christian

doi:10.1080/00015385.2019.1600827

Cited by 12 publications

(19 citation statements)

References 19 publications

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“…fQRS is an electrocardiographic indicator of pre-existing myocardial fibrosis and has been shown to predict cardiac events in several cardiovascular conditions such as coronary artery disease, valvular heart disease, both ischemic and nonischemic cardiomyopathy, idiopathic dilated cardiomyopathy, and arrhythmogenic right ventricular dysplasia (7-10, 30, 31). Pathophysiologically, fQRS has been associated with disrupting the normally homogeneous depolarization process within the myocardium caused by electrically inactive fibrotic tissue, which is believed to be a substrate for arrhythmic events (7,32). In this study, fQRS or CVD alone is not significantly associated with mortality; however, the coexistence of both is an independent predictor of mortality.…”

Section: Discussionmentioning

confidence: 57%

“…Fragmented QRS (fQRS) is a novel marker of ventricular depolarization abnormalities that can occur owing to any condition (e.g., ischemia, scar, fibrosis, myofiber disarray, inflammation, and microvascular abnormality) interfering with the normally homogeneous depolarization process within the myocardium and leading to local conduction slowing (6,7). The presence of fQRS has been linked to adverse outcomes in patients with various CVDs (7)(8)(9)(10). In addition, hypertensive patients with left ventricular hypertrophy showed a significantly greater frequency of fQRS than those without left ventricular hypertrophy (11).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, hypertensive patients with left ventricular hypertrophy showed a significantly greater frequency of fQRS than those without left ventricular hypertrophy (11). Moreover, subclinical left ventricular dysfunction assessed by echocardiography has been proposed to be associated with fQRS in patients with type 2 diabetes (7).…”

Section: Introductionmentioning

confidence: 99%

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Does coexistence of fragmented QRS and cardiovascular disease have the ability to predict the mortality in hospitalized, critically ill patients with COVID-19?

Katkat¹,

Kalyoncuoğlu²,

Karahan³

et al. 2021

The Anatolian Journal of Cardiology

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does coexistence of fragmented QRS and cardiovascular disease have the ability to predict the mortality in hospitalized, critically ill patients with COVID-19?

Katkat¹,

Kalyoncuoğlu²,

Karahan³

et al. 2021

The Anatolian Journal of Cardiology

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“…The term 'fragmentation of the QRS-complex" or "fragmented QRS" (fQRS) point to the existence of high-frequency potentials (spikes) in the QRS-complex [1]. The expression was first described in 1973 in reporting of an experimental study on canine hearts where coronary artery obstruction motivated the occurrence of fragmented electrograms as a source of reentrant activity [2].…”

Section: Introductionmentioning

confidence: 99%

Qrs-Complex Fragmentations and Right Ventricular Infarction in the Presence of Inferior Infarction with Triple-Vessels Disease; Bad Initials but a Good Outcome

Elsayed¹

2022

JTCS

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Rationale: The term “fragmentation of the QRS complex” denotes the existence of high-frequency potentials (spikes) in the QRS-complex. It is either a marker for cardiac structural diseases inducing biventricular hypertrophy or any condition interfering with the normally homogeneous depolarization status inside the myocardium. An associated right ventricular infarction with inferior infarction maybe carry a risk impact and serious complications. Patient concerns: A 64-year-old married, farmer, heavy smoker, Egyptian male patient presented with acute severe chest pain and inferior with right ventricular ST-segment elevation myocardial infarction and fragmentation of the QRS complex. Diagnosis: QRS-complex fragmentations and right ventricular infarction in the presence of inferior infarction with the triple-vessels disease. Interventions: Electrocardiography, oxygenation, streptokinase intravenous infusion, echocardiography, and percutaneous transluminal coronary angioplasty. Outcomes: Dramatic response of acute inferior with right ventricular ST-segment elevation myocardial infarction and QRS-complex fragmentations to streptokinase. Lessons: Despite the presence of inferior and right ventricular ST-segment elevation myocardial infarction with QRS-complex fragmentations, but there is no correlation with the severity of the disease. Dramatic clinical and electrocardiographic response signifying the role of streptokinase and fibrinolytic. The presence of fragmentation of the QRS-complex may have a bidirectional impact from seriousness to complications.

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“…It has been suggested that the mechanism of fQRS production is caused by zigzag conduction around the scarred myocardium and has been associated with aneurysms of the ischemic area (Elibet, 2018). Despite the popularity of fQRS in coronary artery disease or primary electrical abnormalities of depolarization (Brohet, 2019), it is to be emphasized that fQRS is a nonspecific finding and should only be interpreted in the presence of pertinent clinical evidence of myocardial scar as in coronary artery disease or primary electrical abnormalities of depolarization (Das and El, 2010).…”

Section: Introductionmentioning

confidence: 99%

R-Wave Singularity: A New Morphological Approach to the Analysis of Cardiac Electrical Dyssynchrony

Zhan

Shi

et al. 2020

Front. Physiol.

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R-wave singularity (RWS) measures the intermittence or discontinuousness of R waves. It has been broadly used in QRS (QRS complex of electrocardiogram) detection, electrocardiogram (ECG) beats classification, etc. In this article, we novelly developed RWS to the analysis of QRS morphology as the measurement of ventricular dyssynchrony and tested the hypothesis that RWS could enhance the discrimination between control and acute myocardial infarction (AMI) patients. Holter ECG recordings were obtained from the Telemetric and Holter ECG Warehouse database, among which database Normal was extracted as normal controls (n = 202) and database AMI (n = 93) as typical subjects of autonomic nervous system dysfunction and cardiac electrical dyssynchrony with high risk for cardiac arrhythmias and sudden cardiac death. Experimental results demonstrate that RWS measured by Lipschitz exponent calculated from 5-min Holter recordings was significantly less negative in early AMI and late AMI than that in Normal subjects for overall, elderly, and elderly male groups, which suggested the heterogeneous depolarization of the ventricular myocardium during AMI. Receiver operating characteristic curve analyses show that combined with heart rate variability parameters, Lipschitz exponent provides higher accuracy in distinguishing between the patients with AMI and healthy control subjects for overall, elderly, elderly male, and elderly female groups. In summary, our study demonstrates the significance of using RWS to probe the cardiac electrical dyssynchrony for AMI. Lipschitz exponent may be valuable and complementary for existing cardiac resynchronization therapy and autonomic nervous system assessment.

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Fragmentation of the QRS complex: the latest electrocardiographic craze?

Cited by 12 publications

References 19 publications

Does coexistence of fragmented QRS and cardiovascular disease have the ability to predict the mortality in hospitalized, critically ill patients with COVID-19?

Does coexistence of fragmented QRS and cardiovascular disease have the ability to predict the mortality in hospitalized, critically ill patients with COVID-19?

Qrs-Complex Fragmentations and Right Ventricular Infarction in the Presence of Inferior Infarction with Triple-Vessels Disease; Bad Initials but a Good Outcome

R-Wave Singularity: A New Morphological Approach to the Analysis of Cardiac Electrical Dyssynchrony

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