Fragmented QRS Predicts Heart Failure Progression in Patients With Hypertrophic Cardiomyopathy

Nomura, Akihiro; Konno, Tetsuo; Fujita, Takashi; Tanaka, Yoshihiro; Nagata, Yoji; Tsuda, Toshihide; Hodatsu, Akihiko; Sakata, Kenji; Nakamura, Hiroyuki; Kawashiri, Masa‐aki; Fujino, Noboru; Yamagishi, Masakazu; Hayashi, Kenshi

doi:10.1253/circj.cj-14-0822

Cited by 30 publications

(31 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We and others (22,23) reported that the presence of fragmented QRS complexes, defined as the presence of an additional R-wave (R 0 ), notching in the nadir of the S-wave, or the presence of >1 R 0 on the 12-lead ECG, was associated with either heart failure with hospitalization or arrhythmic events in patients with HCM. We also showed, using late gadolinium enhancement in CMR, that fragmented QRS complexes can be markers of myocardial fibrosis in patients with HCM (24).…”

Section: Discussionmentioning

confidence: 99%

J Waves for Predicting Cardiac Events in Hypertrophic Cardiomyopathy

Tsuda

Hayashi

Konno

et al. 2017

JACC: Clinical Electrophysiology

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

J Waves for Predicting Cardiac Events in Hypertrophic Cardiomyopathy

Tsuda

Hayashi

Konno

et al. 2017

JACC: Clinical Electrophysiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Ablation strategy in patients with prolonged QT interval 10 and ventricular arrhythmias. 18, 19 Because the atrial and ventricular myocytes might have similar cardiac ion channel abnormality due to the shared pathological and genetic mechanism of HCM, the QT/corrected QT (QTc) interval, a measurement of ventricular depolarization/repolarization time, 20 could indirectly reflect the electrophysiological profile of atrial myocardium. Actually, QT prolongation has been associated with an increased AF incidence in the general population.…”

Section: Electrophysiology Study and Af Ablationmentioning

confidence: 99%

QTc Interval Prolongation Predicts Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy

Wen

Liu

et al. 2015

Circ J

View full text Add to dashboard Cite

Background:In hypertrophic cardiomyopathy (HCM) patients complicated with atrial fibrillation (AF), catheter ablation has been recommended as a treatment option. Meanwhile, prolongation of QTc interval has been linked to an increased AF incidence in the general population and to poor outcomes in HCM patients. However, whether QTc prolongation predicts arrhythmia recurrence after AF ablation in the HCM population remains unknown. Methods and Results:Thirty-nine HCM patients undergoing primary AF ablation were enrolled. The ablation strategy included bilateral pulmonary vein isolation (PVI) for paroxysmal AF (n=27) and PVI plus left atrial roof, mitral isthmus and tricuspid isthmus linear ablations for persistent AF (n=12). Pre-procedural QTc was corrected by using the Bazett's formula. At a 14.8-month follow up, 23 patients experienced atrial tachyarrhythmia recurrence. Recurrent patients had longer QTc than non-recurrent patients (461.0±28.8 ms vs. 434.3±18.2 ms, P=0.002). QTc and left atrial diameter (LAD) were independent predictors of recurrence. The cut-off value of QTc 448 ms predicted arrhythmia recurrence with a sensitivity of 73.9% and a specificity of 81.2%. A combination of LAD and QTc (global chisquared=13.209) was better than LAD alone (global chi-squared=6.888) or QTc alone (global chi-squared=8.977) in predicting arrhythmia recurrence after AF ablation in HCM patients. Conclusions:QTc prolongation is an independent predictor of arrhythmia recurrence in HCM patients undergoing AF ablation, and might be useful for identifying those patients likely to have a better outcome following the procedure. (Circ J 2015; 79: 1024 -1030

show abstract

“…In a study including 195 patients with HCM followed up for a median period of 5.7 years, Debonnaire et al [16 ]found that patients with fQRS in ≥3 territories were associated with ventricular tachyarrhythmias and SCD. Another study showed that fQRS was associated with HF progression in patients with HCM [17]. However, these studies did not describe the correlation between fQRS and all-cause or CVD mortality.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Wang

Zhu

et al. 2017

Cardiology

View full text Add to dashboard Cite

Objectives: The relationship between a fragmented QRS (fQRS) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) remains unclear.This study aimed to investigate the prognostic significance of fQRS in patients with HCM. Methods: Between 2000 and 2012, 326 unrelated patients with HCM (72% male with a mean age of 52 years) were included and were divided into 2 groups: those with fQRS and those without fQRS. Results: A total of 105/326(32.2%) patients with HCM presented with fQRS at enrollment. During a follow-up of 5.3 ± 2.4 years, 33 patients died, 30 of cardiovascular disease (CVD). Cox regression analysis revealed that fQRS predicted a higher risk of all-cause mortality (adjusted hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.08-4.64; p = 0.030) and CVD mortality (adjusted HR 2.68; 95% CI 1.22-5.91; p = 0.014). Our study also showed that fQRS increased the risk of heart failure-related death (adjusted HR 3.75; 95% CI 1.24-11.30; p = 0.019). Conclusions: Our results indicate that fQRS is associated with adverse clinical outcomes in patients with HCM.

show abstract

Fragmented QRS Predicts Heart Failure Progression in Patients With Hypertrophic Cardiomyopathy

Cited by 30 publications

References 41 publications

J Waves for Predicting Cardiac Events in Hypertrophic Cardiomyopathy

J Waves for Predicting Cardiac Events in Hypertrophic Cardiomyopathy

QTc Interval Prolongation Predicts Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy

Prognostic Significance of Fragmented QRS in Patients with Hypertrophic Cardiomyopathy

Contact Info

Product

Resources

About