The Predictive Value of Fragmented QRS and QRS Distortion for High-Risk Patients with STEMI and for the Reperfusion Success

Abstract

fQRS and QRS distortion may be useful for identifying patients at higher cardiac risk. fQRS can foresee thrombolytic therapy failure and three vessels disease whereas QRS distortion does not possess such quality. These findings may guide the physician deciding initial treatment modality in STEMI.

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

“…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.…”

“…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).…”

“…[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.…”

The usefulness of fQRS and QRS distortion for predicting reperfusion success and infarct-related artery patency in patients who underwent thrombolytic therapy

“…These findings may partly explain the reason for the higher ratio of failed thrombolysis in patients with fQRS on admission ECG in our study. In addition, Çetin et al [37] showed that coronary atherosclerotic burden and extent of coronary artery disease were related to fQRS, and in our previous study, we found that proximal lesions and threevessel disease were more frequent in patients with fQRS [28]. In acute STEMI patients with fQRS, the presence of complex coronary lesions loaded with more intensive thrombus may be greater, leading to TT failure.…”

“…The presence of fQRS and QRS distortion on admission ECG may be evaluated for this purpose as it affects the acute STEMI myocardial depolarization. In a previous study, we presented the relationship between fQRS (which was developed over a follow-up period of 48 h) and unsuccessful thrombolysis by ECG [28]. Our current study is very important as it shows that TT will most likely be unsuccessful in acute STEMI patients in whom fQRS was detected on admission ECG with angiographic reperfusion criteria and electrocardiographic reperfusion criteria.…”