Prognostic significance of quantitative QRS duration

Desai, Aseem D.; Yamazaki, Takuya; Kaykha, Amir; Chun, Sung; Froelicher, Victor

doi:10.1016/s0735-1097(03)80664-2

Cited by 27 publications

(31 citation statements)

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“…12,29 A large-scale study involving 46,933 veterans revealed that BBB and paced QRS were predictors of cardiovascular mortality. 30 Similarly, many other studies have shown that wQRS itself is a predictor of mortality in patients with CAD, but our study further identifies f-wQRS as a marker of the higher risk population (f-BBB, f-PVC, and f-QRS) in the wQRS group. [31][32][33] Our study does not provide the mechanism of death in patients with f-wQRS.…”

Section: F-wqrs As a Predictor Of Mortalitysupporting

confidence: 84%

Fragmented Wide QRS on a 12-Lead ECG

Das

Suradi

Maskoun

et al. 2008

Circ: Arrhythmia and Electrophysiology

320

125

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Background-Fragmented QRS (duration Ͻ120 ms) on a 12-lead ECG represents myocardial scar in patients with coronary artery disease. However, the significance of fragmented QRS has not been defined in the presence of a wide QRS (wQRS; duration Ն120 ms). We postulate that fragmented wQRS (f-wQRS) due to bundle branch block, premature ventricular complexes, or paced rhythms (f-pQRS) signify myocardial scar and higher mortality. Methods and Results-Patients who underwent cardiac evaluation with nuclear stress imaging or cardiac catheterization and had wQRS (bundle branch block, premature ventricular complex, or pQRS) were studied. f-wQRS was defined by the presence of Ͼ2 notches on the R wave or the S wave and had to be present in Ն2 contiguous inferior (II, III, aVF), lateral (I, aVL, V 6 ) or anterior (V 1 to V 5 ) leads. ECG analyses of 879 patients (age, 66.7Ϯ11.4 years; male, 97%; mean follow-up, 29Ϯ18 months) with bundle branch block (nϭ310), premature ventricular complex (nϭ301), and pQRS (nϭ268) revealed f-wQRS in 415 (47.2%) patients. Myocardial scar was present in 440 (50%) patients. The sensitivity, specificity, positive predictive value, and negative predictive value of f-wQRS for myocardial scar were 86.8%, 92.5%, 92.0%, and 87.5%, respectively. The sensitivity and specificity for diagnosing myocardial scar were 88.6% and 94.4%, 81.4% and 88.4%, and 89.8% and 95.7% for f-bundle branch block, f-premature ventricular complex, and f-pQRS, respectively. f-wQRS was associated with mortality after adjusting for age, ejection fraction, and diabetes (Pϭ0.017). Conclusions-f-wQRS on a standard 12-lead ECG is a moderately sensitive and highly specific sign for myocardial scar in patients with known or suspected coronary artery disease. f-wQRS is also an independent predictor of mortality. (Circ Arrhythmia Electrophysiol. 2008;1:258-268.)

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Section: F-wqrs As a Predictor Of Mortalitysupporting

confidence: 84%

Fragmented Wide QRS on a 12-Lead ECG

Das

Suradi

Maskoun

et al. 2008

Circ: Arrhythmia and Electrophysiology

320

125

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“…26 In a broad sample of patients receiving an ECG at the VA Palo Alto Health Care System in Palo Alto, Calif, 801 (1.8%) of 44 280 had a QRS duration Ͼ120 ms, and an additional 2300 had either right or left bundle-branch block. 27 Estimates of the prevalence of QRS prolongation in the population with chronic congestive heart failure range between 20% and 50%, 28 consistent with the notion that QRS prolongation becomes more prevalent in patients with advancing heart disease. Observational studies suggest that QRS prolongation is a significant marker for poor outcome in patients with depressed LVEF, especially due to coronary artery disease.…”

Section: Qrs Durationmentioning

confidence: 70%

American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death

Goldberger¹,

Cain²,

Hohnloser³

et al. 2008

Circulation

780

361

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“…16 In a general medical inpatient and outpatient cohort of patients without BBB, an increase in QRSd from Յ110 to Ͼ130 ms was associated with a 1.8-fold increased risk of cardiovascular death. 17 Furthermore, in hypertensive patients with left ventricular hypertrophy, prolonged QRSd predicted all-cause and cardiovascular mortality 18 and identified patients at higher risk for sudden cardiac death. 19 Prolonged QRS duration, especially BBB, is known to correlate with age.…”

Section: Discussionmentioning

confidence: 99%

Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in the General Population

Anttonen

Tikkanen

et al. 2011

Circ: Arrhythmia and Electrophysiology

158

105

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Background-Prolonged duration of QRS complex in a 12-lead ECG is associated with adverse prognosis in patients with cardiac disease, but its significance is not well established in the general population. In particular, there is a paucity of data on the prognostic significance of nonspecific intraventricular conduction delay in apparently healthy subjects. Methods and Results-We evaluated the 12-lead ECGs of 10 899 Finnish middle-aged subjects from the general population (52% of whom were men; mean age 44Ϯ8.5 years) between 1966 and 1972 and followed them for 30Ϯ11 years. Primary end points were all-cause mortality, cardiac mortality, and arrhythmic death. Prolonged QRS duration was defined as QRS Ն110 ms and intraventricular conduction delay as QRS Ն110 ms, without the criteria of complete or incomplete bundle-branch block. QRS duration Ն110 ms was present in 1.3% (nϭ147) and intraventricular conduction delay in 0.6% (nϭ67) of the subjects.

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Prognostic significance of quantitative QRS duration

Cited by 27 publications

References 0 publications

Fragmented Wide QRS on a 12-Lead ECG

Fragmented Wide QRS on a 12-Lead ECG

American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death

Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in the General Population

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