Predictive Value of a Fragmented QRS Complex in Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction

Akgül, Özgür; Uyarel, Hüseyin; Püşüroğlu, Hamdi; Surgit, Özgür; Turen, Selahattin; Ertürk, Mehmet; Ayhan, Erkan; Bulut, Ümit; Baycan, Ömer Faruk; Demir, Ali; Uslu, Nevzat

doi:10.1111/anec.12179

Cited by 35 publications

(57 citation statements)

References 32 publications

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“…9-12, 16, 17 Six studies reported in-hospital adverse events, thus it may be assumed that no cases were lost to follow-up. [13][14][15][16][17][18] In addition, it was not clear how three studies accounted for potential confounders, raising the small possibility of result distortion. 13,15,18 The funnel plot did not suggest evidence of publication bias (Fig.…”

Section: Study Qualitymentioning

confidence: 99%

“…The mean age of cases ranged from 54 to 71 years in fQRS (+) groups and 55 to 62 years in the fQRS (-) groups. Five studies included patients only with STEMI (n = 1398) 9, [14][15][16]18 and three studies included patients only with NSTEMI (n = 761). 10, 12, 17 Two studies included patients with both STEMI and NSTEMI (n = 607).…”

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

“…[3][4][5][6][7] In addition, various studies have evaluated the prognostic importance of fQRS in patients with acute coronary syndrome (ACS), ST-segment elevation (STEMI), or non-ST segment elevation myocardial infarction (NSTEMI). [8][9][10][11][12][13][14][15][16][17][18] Some recent papers reviewed the clinical importance of fQRS in patients with cardiovascular diseases. [19][20][21] However, the literature regarding the definition and the prognostic value of fQRS in patients with AMI is heterogeneous and the findings are not easy to interpret.…”

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confidence: 99%

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Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis

Güngör

Özcan²,

Karataş

et al. 2016

Noninvasive Electrocardiol

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We searched PubMed, Embase, Web of Science, and Cochrane Library up to October 2015 for eligible studies. We selected studies with fQRS defined with 12-lead ECG during the index hospitalization of STEMI/NSTEMI. Primary outcomes were in-hospital and long-term cardiovascular events. In-hospital mortality was significantly higher in fQRS (+) group (99/733; 13.5%) compared to fQRS (-) group (47/1293; 3.6%) (OR 4.03 95% CI 1.81-8.94; P = 0.0006). Long-term mortality rate was higher in fQRS (+) group (89/473; 18.8%) compared to fQRS (-) group (54/1009; 5.3%) (OR 3.93 95% CI 1.92-8.05; P = 0.0002). In addition the frequency of long-term MACE was higher in fQRS (+) group (46.9%) compared to fQRS (-) group (14.6%) (OR 5.13 95% CI 2.77-9.51; P < 0.00001) CONCLUSION: Presence of fQRS on admission ECG was found to be predictor of mortality, MACE, deterioration of LV function, and presence of multivessel disease in patients with STEMI and NSTEMI.

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Section: Study Qualitymentioning

confidence: 99%

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

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confidence: 99%

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Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis

Güngör

Özcan²,

Karataş

et al. 2016

Noninvasive Electrocardiol

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“…Various RSR' patterns include an additional R wave (R') or notching in the nadir of the S wave, or the presence of > 1 R' (fragmentation) in 2 contiguous leads, corresponding to a major coronary artery territory [8]. Fragmented QRS has been shown to be a marker of myocardial fibrosis or scar tissue, and has been found to be associated with increased adverse cardiac events [9,10]. The aim of this study was to determine if fQRS is more common in MetS patients and if the presence of fQRS on ECG can detect pronounced impairment in LV systolic and diastolic functions in MetS patients.…”

Section: Introductionmentioning

confidence: 99%

Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Oner

Ertürk²,

Birant³

et al. 2015

Cardiol J.

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041). MetS was associated with subclinical LV systolic and LV diastolic dysfunctions. In subgroup analyses of MetS patients, the presence of fQRS on ECG had a higher E/E' ratio and lower E' velocity, indicating pronounced diastolic dysfunction, as well as lower isovolumic acceleration (IVA), indicating profound subclinical LV systolic dysfunction. E/E' ratio and IVA were independent predictors of fQRS presence in patients with MetS. Conclusions: Fragmented QRS is more common among MetS patients compared to non--MetS patients. The presence of fQRS is associated with pronounced subclinical LV systolic and diastolic dysfunctions in MetS patients. (Cardiol J 2015; 22, 6: 691-698)

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“…Fragmenta- on f-QRS, often appearing in the application, was associated with a higher risk of VT/VF in patients with acute MI, including those with primary PCI [11]. One of the studies of f-QRS has shown that in the short-term follow-up of patients after ACS, who underwent PCI and were f-QRS-negative, no statistically significant differences were found in the growth of malignant cardiac arrhythmias compared with the patients who underwent PCI and their fragmentation was presented [3].…”

Section: Resultsmentioning

confidence: 97%

Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively

et al. 2016

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A b s t r a c tBackground: Previous studies showed that the presence of fragmented QRS (f-QRS) in patients with acute coronary syndrome (ACS), who underwent complete revascularisation, is associated with worse prognosis and the possibility of arrhythmia occurrence. Aim:To assess the prognostic value of f-QRS in patients with ACS and complete revascularisation, in the context of cardiac arrhythmias. Methods:We analysed 124 consecutive patients (66.1% males; mean age 62.38 ± 11.0 years) with ACS (STEMI 49%) treated invasively. Based on electrocardiogram (ECG) record, performed during the admission to the clinic, after the complete revascularisation (TIMI = 3) and during discharging from hospital (4 th -5 th days after ACS), we classified QRS as f-QRS based on generally accepted criteria (QRS < 120 ms, which included an additional R wave [R']) or notching in the nadir of the S wave, or > 1 R' (fragmentation) in two contiguous leads, corresponding to a major coronary artery territory. 24-h Holter ECG recording was performed on the fifth day after ACS to assess the frequency of conduction disturbances and others arrhythmias.Results: There were no statistically significant differences between patients with and without f-QRS during hospitalisation. In the patients with f-QRS there were no statistically significant conduction disturbances and other arrhythmias compared to patients without f-QRS at discharge. Conclusions:In the patients with ACS, who underwent successful revascularisation (TIMI = 3), the presence of f-QRS is not correlated with a higher incidence of arrhythmias compared to patients without f-QRS in short-term follow-up.

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Predictive Value of a Fragmented QRS Complex in Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction

Abstract: These results suggest that the presence of fQRS on ECG was associated with an increased in-hospital cardiovascular mortality, and one-year all-cause mortality in patients with STEMI who are under primary PCI.

Cited by 35 publications

References 32 publications

Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis

Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis

Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively

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