Fragmented QRS for Risk Stratification in Patients Undergoing First Diagnostic Coronary Angiography

Eyuboglu, Mehmet; Ekinci, Mehmet; Karakoyun, Süleyman; Küçük, Uğur; Şenarslan, Ömer; Akdeniz, Bahri

doi:10.5935/abc.20160139

Cited by 13 publications

(12 citation statements)

References 21 publications

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“…[ 4 , 9 , 22 ] In patients with LD, most left ventricular myocardial are supplied by the poster lateral branches and posterior descending artery originating from the left circumflex artery. [ 23 ] In contrast, the IVS is supplied by the posterior descending branch of the RCA in individuals with RD. Additionally, the IVS is shared by the RCA and left circumflex artery in CD.…”

Section: Discussionmentioning

confidence: 99%

Impact of right coronary dominance on triple-vessel coronary artery disease

Peng

Guo

Gao³

et al. 2018

Medicine

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This study was conducted to investigate the relationship between right coronary dominance and coronary angiographic characteristics in patients with or without significant coronary artery disease (CAD).A total of 2225 patients undergoing coronary angiography (CAG) between January 2011 and November 2014 were recruited in our study. Based on the CAG results, patients were divided into the left dominance (LD) group, right dominance (RD) group, and co-dominance (CD) group. Multinomial logistic regression was applied to analyze the relationships between coronary dominance and triple-vessel CAD.We found that patients with RD had a higher prevalence of triple-vessel CAD (36.6% vs 27.3%, P = .008) and significant stenosis in the right coronary artery (40.5% vs 29.2%, P = .001). In addition, results of multinomial logistic regression analysis showed that RD was significantly associated with the triple-vessel disease (odds ratio 1.768, 95% confidence interval 1.057–2.956, P = .030).In conclusion, RD positively correlated with triple-vessel CAD rather than LD or CD in patients. This result suggested that RD may serve as a risk factor for triple-vessel CAD and more effective measures should be taken in RD patients to prevent fatal cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Impact of right coronary dominance on triple-vessel coronary artery disease

Peng

Guo

Gao³

et al. 2018

Medicine

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“…Fragmented QRS is a novel ECG parameter that is used quite often in daily practice and that is gaining importance. 23 However, the number of fQRS derivations has recently attracted a greater interest. Even though there is no study showing the importance of the presence of fQRS in a single lead, the clinical significance of QRS distortion in only one lead, which is another important ECG finding in acute STEMI, 24 was investigated in a recently published study.…”

Section: Discussionmentioning

confidence: 99%

Single Derivation Fragmented QRS Can Predict Poor Prognosis in Successfully Revascularized Acute STEMI Patients

Tanriverdi

Dursun

Colluoglu

et al. 2017

Arquivos Brasileiros De Cardiologia

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BackgroundQRS fragmentation (fQRS) is classically defined as the presence of slurred QRS morphology in at least two contiguous leads, and its prognostic importance has been shown in ST elevation myocardial infarction (STEMI). However, no study has investigated the significance of single lead fQRS (sl-fQRS) in surface electrocardiography (ECG).ObjectivesTo evaluate whether sl-fQRS is as valuable as classical fQRS in patients with acute STEMI who had successful revascularization with primary percutaneous coronary intervention (pPCI).MethodsWe included 330 patients with a first STEMI who had been successfully revascularized with pPCI. The patient’s electrocardiography was obtained in the first 48 hours, and the patients were divided into three groups according to the absence of fQRS (no-fQRS); fQRS presence in a single lead (sl-fQRS); and ≥2 leads with fQRS (classical fQRS).ResultsIn-hospital mortality was significantly higher both in patients with sl-fQRS and in patients with ≥ 2 leads with fQRS compared to patients with no-fQRS. In ROC curve analysis, ≥ 1 leads with fQRS yielded a sensitivity of 75% and specificity of 57.4% for the prediction of in-hospital mortality. Multivariate analysis showed that sl-fQRS is an independent predictor of in-hospital mortality (OR: 3.989, 95% CI: 1.237-12.869, p = 0.021).ConclusionsAlthough the concept of at least two derivations is mentioned for the classical definition of fQRS, our study showed that fQRS in only one lead is also associated with poor outcomes. Therefore, ≥1 leads with fQRS can be useful when describing the patients under high cardiac risk in acute STEMI.

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“…One study by Eyuboglu M showed the frequency of f QRS as 23.5% 4 in NSTEMI patients versus another study by Min Li showing the frequency of 55.56%. 2 But no published study available in local setting to tell us about the prevalence of this finding in our local population.…”

Section: Introductionmentioning

confidence: 95%

“…4 fQRS complexes are a new ECG indicator, which shows delay in conduction of electrical current in coronary artery disease patients. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] One study found that 23.5% cases of NSTEMI patients had f QRS. 3 But another study revealed that fQRS complex was seen in 66.5% cases of NSTEMI.…”

Section: Wwwtheprofesionalcom 64mentioning

confidence: 99%

Frequency of fragmented QRS in patients with acute Non ST elevation Myocardial Infarction (NSTEMI).

Yasir

Usman

Ahmed

et al. 2021

TPMJ

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Objective: To determine the frequency of fragmented QRS complex in patients with acute non-ST elevation myocardial infarction (NSTEMI). Study Design: Cross-Sectional Study. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: July 15, 2019 to January 15, 2020. Material & Methods: One hundred and forty five diagnosed patients of NSTEMI on the basis of chest pain and positive troponin-I were included in this study. The electrocardiography (ECG) was performed to document the presence or absence of f QRS complex in these patients. A 12-lead ECG with paper speed of 25 or 50 mm per second and a voltage of 10 mm/mv was used. FQRS was labeled (as per operational definition). The collected data were entered and analyzed statistically by using SPSS v25.0. Data were stratified for age, gender, diabetes, smoking and hypertension. Post-stratification, f QRS complex was compared by Chi-Square test in stratified groups. A p-value ≤0.05 was taken as significant. Results: Total 145 patients presenting with NSTEMI were selected for this study. Mean age of the patients was 48.2±12.3 year. Among these patients, 90(62.1%) were males, while 55(37.9%) were females. Overall frequency of fQRS complex in patients with NSTEMI was 64(44.1%). Conclusion: There is an association of fQRS among patients with acute non-ST elevation myocardial infarction (NSTEMI). Further prospective studies are needed to determine the clinical significance of fQRS complex and identify its correlation with the incidence of possible complications.

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Fragmented QRS for Risk Stratification in Patients Undergoing First Diagnostic Coronary Angiography

Cited by 13 publications

References 21 publications

Impact of right coronary dominance on triple-vessel coronary artery disease

Impact of right coronary dominance on triple-vessel coronary artery disease

Single Derivation Fragmented QRS Can Predict Poor Prognosis in Successfully Revascularized Acute STEMI Patients

Frequency of fragmented QRS in patients with acute Non ST elevation Myocardial Infarction (NSTEMI).

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