Predictive value of fragmented QRS for ventricular tachyarrhythmias in patients with acute myocardial infarction: A meta‐analysis

Abstract

Background Recent studies indicated that fragmented QRS (fQRS) is associated with malignant cardiac arrhythmias in patients with acute myocardial infarction (AMI). However, a systematic review and meta‐analysis on this issue still have not been conducted. Thus, we performed a systematic review and meta‐analysis to access the predictive value of fQRS for ventricular tachyarrhythmias (VTAs) in patients with AMI. Materials and Methods We searched the databases of PubMed, Embase and Cochrane Library for relevant studies until 8 June 2019. We included studies which compared VTAs in AMI patients with fQRS vs without fQRS. Results Six studies enrolling 2218 ST‐segment elevation myocardial infarction (STEMI) patients were included in this meta‐analysis. The fQRS was significantly associated with greater risk of VTAs in STEMI patients (Odds ratio [OR] 2.81, 95% confidence interval (CI) 1.99‐3.95, P < .00001; I2 = 30%). This association was still significant both in prospective (OR 3.25, 95% CI 1.94‐5.46, P < .00001; I2 = 0%) and retrospective (OR 2.40, 95% CI 1.22‐4.74, P = .01; I2 = 54%) studies. In particularly, fQRS in patients with low left ventricular ejection fraction (≤50%) (OR 2.97, 95% CI 1.88‐4.70, P < .00001; I2 = 21%) or <60 years old (OR 3.07, 95% CI 2.02‐4.66, P < .00001; I2 = 0%) tripled the risk of VTAs during AMI. Conclusion Our meta‐analysis demonstrated that fQRS increases the risk of developing VTAs in patients with STEMI.

Cardiac ischemia and reperfusion in mice: a comprehensive hemodynamic, electrocardiographic and electrophysiological characterization

“…In addition, specific fQRS complex was documented in 14 out of 18 I/R mice. In contrast to humans, though, fQRS was not clearly associated with VA after acute MI in the small murine population we examined here 16 . Finally, I/R mice showed prolonged ventricular repolarization indices such as QT, QTc and JTc.…”

Fragmented QRS, a strong predictor of mortality and major arrhythmic events in patients with nonischemic cardiomyopathy: A systematic review and meta‐analysis

“…EF was observed to be significantly negatively related to the presence of fQRS in the patients with acute myocardial infarction, 14 takotsubo cardiomyopathy, 71 and nonischemic dilated cardiomyopathy 36 . Furthermore, the correlation between fQRS and elevated risk of ventricular tachyarrhythmias was found to be more notable in patients with low LVEF (≤50%) 72 . Also, a study demonstrated that fQRS was a potential predictor of HF and hospitalization due to HF in patients with HCM, likely indicating poor prognosis 45 …”

“…36 Furthermore, the correlation between fQRS and elevated risk of ventricular tachyarrhythmias was found to be more notable in patients with low LVEF (≤50%). 72 Also, a study demonstrated that fQRS was a potential predictor of HF and hospitalization due to HF in patients with HCM, likely indicating poor prognosis. 45 As another explanation, fQRS was reported to be significantly associated with the thickness of epicardial adipose tissue (EAT).…”