Prognostic value of fragmented QRS on a 12-lead ECG in patients with acute myocardial infarction

Lorgis, Luc; Jourda, François; Hachet, Olivier; Zeller, Marianne; Gudjoncik, Aurélie; Dentan, Gilles; Stamboul, Karim; Guenancia, Charles; Mock, Laurent; Cottin, Yves

doi:10.1016/j.hrtlng.2013.05.005

Cited by 32 publications

(43 citation statements)

References 18 publications

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“…13 and persistent QRS fragmentation subgroups. 11 The rate of transient fQRS in the study populations ranged between 12.5% and 54%. 11,13,18 The rates of permanent QRS fragmentation ranged between 3% and 74%.…”

Section: Qrs Fragmentationmentioning

confidence: 91%

“…11 The rate of transient fQRS in the study populations ranged between 12.5% and 54%. 11,13,18 The rates of permanent QRS fragmentation ranged between 3% and 74%. 10,11,13,14,18 When, only patients with STEMI were considered, the rate of fQRS persistence was reported as 27% and 66%.…”

Section: Qrs Fragmentationmentioning

confidence: 91%

“…10, 12, 17 Two studies included patients with both STEMI and NSTEMI (n = 607). 11,13 In total, 1626 patients (58.7%) had STEMI and 1440 patients had NSTEMI (41.3%).…”

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

“…9,11,[16][17][18] Five studies reported the persistence of QRS fragmentation during the hospitalization or followup period. 10,11,13,14,18 Two studies included subjects with transient QRS fragmentation in the control group 10,14 and two studies included cases with transient QRS fragmentation in the fQRS (+) group. 13 and persistent QRS fragmentation subgroups.…”

Section: Qrs Fragmentationmentioning

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: Qrs Fragmentationmentioning

confidence: 91%

Section: Qrs Fragmentationmentioning

confidence: 91%

“…10, 12, 17 Two studies included patients with both STEMI and NSTEMI (n = 607). 11,13 In total, 1626 patients (58.7%) had STEMI and 1440 patients had NSTEMI (41.3%).…”

Section: Baseline Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Qrs Fragmentationmentioning

confidence: 99%

mentioning

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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QRS fragmentation does not predict mortality in survivors of acute myocardial infarction

Allescher,

Sinnecker,

von Goeldel

et al. 2024

Clinical Cardiology

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BackgroundDespite advances in coronary revascularization and in heart failure management, myocardial infarction survivors remain at substantially increased mortality risk. Precise risk assessment and risk‐adapted follow‐up care are crucial to improve their outcomes. Recently, the fragmented QRS complex, i.e. the presence of additional spikes within the QRS complexes on a 12‐lead electrocardiogram, has been discussed as a potential non‐invasive risk predictor in cardiac patients.HypothesisThe aim of this study was to evaluate the prognostic meaning of the fragmented QRS complex in myocardial infarction survivors.Methods609 patients with narrow QRS complexes <120 ms were included in a prospective cohort study while hospitalized for myocardial infarction and followed for 5 years.ResultsThe prevalence of the fragmented QRS complex in these patients amounted to 46.8% (285 patients). These patients had no increased hazard of all‐cause death (HR 0.84, 95%–CI 0.45–1.57, p = 0.582) with a mortality rate of 6.0% compared to 7.1% in patients without QRS fragmentations. Furthermore, the risks of cardiac death (HR 1.28, 95%–CI 0.49–3.31, p = 0.613) and of non‐cardiac death (HR 0.6, 95%–CI 0.26–1.43, p = 0.25) were not significantly different in patients with QRS fragmentations. However, patients with QRS fragmentations had increased serum creatine kinase concentrations (1438U/l vs. 1160U/l, p = 0.039) and reduced left ventricular ejection fractions (52% vs. 54%, p = 0.011).ConclusionsThe hypothesis that QRS fragmentation might be a prognostic parameter in survivors of myocardial infarction was not confirmed. But those with QRS fragmentation had larger myocardial infarctions, as measured by creatine kinase and left ventricular ejection fraction.

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Time-Domain Analysis of the Electrocardiogram

Chouvarda

Filos

Maglaveras

2019

Series in BioEngineering

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Prognostic value of fragmented QRS on a 12-lead ECG in patients with acute myocardial infarction

Cited by 32 publications

References 18 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

QRS fragmentation does not predict mortality in survivors of acute myocardial infarction

Time-Domain Analysis of the Electrocardiogram

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