QRS fragmentation: Diagnostic and prognostic significance

Pietrasik, Grzegorz; Zaręba, Wojciech

doi:10.5603/cj.2012.0022

Cited by 116 publications

(93 citation statements)

References 30 publications

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“…Based on the results of the study, we noticed that a reduced LVEF below 35% combined with the presence of f-QRS has a value of bad prognosis, which confirmed earlier studies [14]. In the tion of narrow QRS (< 120 ms) is defined as an additional R (R') wave or an incision within the S wave or the presence of at least 2 R-waves in two contiguous leads corresponding to the area by the relevant vasculature coronary artery [9]. The presence of f-QRS ECG was associated with a heterogeneous, "zig-zag" scar formed around the conduction within the myocardium [3].…”

Section: Resultssupporting

confidence: 77%

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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Section: Resultssupporting

confidence: 77%

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

et al. 2016

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“…To date, many applications have been suggested for this novel marker as a clue to variable ischaemic and non-ischaemic cardiac diseases [16]. The diagnostic and prognostic significance of fQRS as well as the suitability for risk stratification have been studied by several researches.…”

Section: Discussionmentioning

confidence: 99%

“…A classic fQRS is only a narrow complex with duration less than 120 ms [16]. According to this definition, we did not include in our systematic review the diagnostic studies that consisted of wide fragmented complexes [6,7].…”

Section: Fragmented Qrs Vs F-w-qrs Complexesmentioning

confidence: 99%

“…There are several reports that show correlation between fQRS and other cardiac diseases [16] such as ventricular arrhythmias and idiopathic ventricular fibrillation [18], Brugada and acquired long QT syndromes [19], and a variety of structural heart diseases such as idiopathic dilated and hypertrophic cardiomyopathies [20], Chagas' cardiomyopathy [21], and miscellaneous diseases such as Behcet's disease [22] and sarcoidosis [23]. Also, some studies reported fQRS as a normal LR -likelihood ratio; DOR -diagnostic odds ratio variant in the elderly population [24], who are a significant part of suspected CAD patients.…”

Section: Fragmented Qrs Specificitymentioning

confidence: 99%

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Diagnostic value of fragmented QRS complex in myocardial scar detection: systematic review and meta-analysis of the literature

et al. 2016

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A b s t r a c t Background and aim:The present study aimed to investigate the diagnostic value of fragmented QRS complex (fQRS) on 12-lead electrocardiogram (ECG) for myocardial scar detection, and presented the results in a systematic review and meta-analysis format.Methods: Medline, SCOPUS, and ISI Web of Knowledge were searched electronically with "Fragmented QRS" or "fQRS" as key words. All related studies that had evaluated the accuracy of fQRS for myocardial scar diagnosis were included.Results: Eight studies (2560 patients) were finally included in the systematic review. Specificity assessment could be evaluated only by five out of these eight articles. Overall pooled sensitivity of fQRS, Q wave, and mixed Q-fQRS was 68% (65-71), 51% (47-55), and 74% (69-79) and the pooled specificity was 80% (79-81), 97% (97-98) and 92% (91-93), respectively. Conclusions:Fragmented QRS is a novel ECG marker with more sensitivity and less specificity than Q wave. A combination of fQRS with Q wave in a 12-lead ECG results in up to 74% sensitivity and 92% specificity. Additional studies are needed to assess the significance of this ECG parameter for regional myocardial scar detection.

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“…Heart failure is commonly seen in patients with a large area of myocardial infarction (>40%) and sometimes results in cardiogenic shock. FQRS has been proved to be valuable tool for predicting the incidence of malignant cardiac arrhythmia and left ventricular systolic dysfunction (4).The presence of fQRS on ECG is associated with myocardial scarring, ischemia, and fibrosis and originates from deterioration in the process of signal transduction and ventricular depolarization (5). The presence of fQRS in coronary artery disease (CAD) patients is known to be significantly associated with MACE, left ventricular dysfunction, and impairment of myocardial perfusion (6,7).…”

Section: Issn: 2320-5407mentioning

confidence: 99%

Impact of QRS Complex Fragmentation on Hospital Outcome of Patients Undergoing Primary Percutaneous Coronary Intervention.

Badawi¹,

Mahfouz²,

Moustafa³

et al. 2017

IJAR

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QRS fragmentation: Diagnostic and prognostic significance

Cited by 116 publications

References 30 publications

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

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

Diagnostic value of fragmented QRS complex in myocardial scar detection: systematic review and meta-analysis of the literature

Impact of QRS Complex Fragmentation on Hospital Outcome of Patients Undergoing Primary Percutaneous Coronary Intervention.

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