QRS fragmentation in standard ECG as a diagnostic marker of arrhythmogenic right ventricular dysplasia–cardiomyopathy

Peters, Stefan; Trümmel, Martina; Koehler, Brigitte

doi:10.1016/j.hrthm.2008.07.012

Cited by 143 publications

(103 citation statements)

References 8 publications

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“…marker of depolarization abnormality and myocardial scar in patients with coronary artery disease (Varriale and Chryssos 1992;Das et al 2006;Michael et al 2007;Das et al 2009). Additionally, fQRS has been demonstrated as a marker of increased mortality and arrhythmic events in patients with ischemic cardiomyopathy ), arrhythmogenic right ventricular dysplasia/cardiomyopathy (Peters et al 2008) and Brugada syndrome (Morita et al 2008). More importantly, it has been shown that the presence of fQRS in ≥2 contiguous leads predicts myocardial scar in patients with coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Fragmented QRS Is Predictive of Myocardial Dysfunction, Pulmonary Hypertension and Severity in Mitral Stenosis

Yüce

Davutoğlu

Ozbala

et al. 2010

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 99%

Fragmented QRS Is Predictive of Myocardial Dysfunction, Pulmonary Hypertension and Severity in Mitral Stenosis

Yüce

Davutoğlu

Ozbala

et al. 2010

Tohoku J. Exp. Med.

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“…The cardiovascular events increasing effect is thought to be associated with myocardial scarring and/or the presence of fibrosis, leading to nonhomogeneous myocardial electrical activity (9). Indeed, studies have revealed that the presence of fQRS is correlated with cardiac structural abnormality, ventricular arrhythmia, myocardial scarring and fibrosis (8)(9)(10)(11) studies showing an association between presence of fQRS and myocardial function and prognosis in patients with NS, Perlini et al (25) demonstrated elevated fQRS in patients with AL amyloidosis and showed that this was correlated with prognosis. AL amyloidosis is a clinical picture observed together with renal and cardiac involvement and one that can lead to NS.…”

Section: Discussionmentioning

confidence: 99%

“…Studies to date have shown that presence of fQRS is associated with a rise in cardiovascular event incidence and cardiovascular mortality and morbidity. This association is thought to stem from myocardial scarring, ventricular arrhythmia and structural cardiac defects (7)(8)(9)(10)(11). There are no previous studies evaluating the relationship between presence of fQRS and myocardial functions in NS patients.…”

Section: Introductionmentioning

confidence: 99%

Presence of fragmented QRS and its correlation with myocardial performance index in patients with nephrotic syndrome

Özkan

Adar²,

Ulusoy³

et al. 2014

Anadolu Kardiyol Derg

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Objective: More cardiovascular events are seen in nephrotic syndrome (NS) patients than in the normal population. Fragmented QRS (fQRS) includes various RSR' patterns with different morphologies of the QRS complexes with or without the Q wave on a resting 12-lead ECG. A relationship between the presence of fQRS and myocardial function impairment has been shown in several studies. The purpose of this study was to evaluate the presence of fQRS in this patient group and the relationship with myocardial functions. Methods: Thirty-four NS patients were included in the cross-sectional study. Demographic data were recorded, and electrocardiograms (ECGs) were analyzed for the presence of fQRS following investigation of biochemical parameters and 24-h protein excretion. In addition to classic echocardiographic parameters, the myocardial performance (Tei index) was calculated as an indicator of cardiac function. For comparison of group's data Student's t-test and Mann-Whitney U test were used. Multiple linear regression analysis was performed for parameters affecting presence of fQRS. Results: We identified fQRS in half of our patients group. Patients with fQRS had significantly greater proteinuria level and Tei index than those without (p<0.05 and p<0.001, respectively). Tei index was also affected presence of fQRS (p<0.05, β=0.45, R 2 =0.32) and positively correlated with proteinuria levels (p<0.05 r=0.366). Conclusion: We demonstrated, for the first time in the literature, that the determination of fQRS in patients with NS in surface ECG, an easily accessible technique, can be used as a parameter in the prediction of myocardial functions. (Anadolu Kardiyol Derg 2014; 14: 450-5)

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“…Most of these signs are incorporated in typical fQRS. fQRS will probably simplify the ECG diagnosis of ARVD/C in patients with a high probability of the disease [19].…”

Section: Non-coronary Artery Disease (Non-cad)mentioning

confidence: 99%

QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

Abdelrahman¹

2013

WJCS

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Background-Rationale of the Study: Among several invasive and non-invasive tests for risk stratification of acute coronary syndromes (ACS), fewer markers can be utilized in clinical practice. Our rationale is to validate use of QRS-fragmentation as a promising bed-side test for assessment of prognosis in those patients. Methods and Results: Collection of two-hundred and twenty patients with ACS was done during two years (from January 2011 till January 2013). Significant organic vaLVe disease and QRS duration ≥ 120 ms as well as patients with permanent pacemakers were excluded. Patients were subjected to full clinical examination, ECG and Echocardiography in the first day of admission followed by diagnostic coronary angiography before discharge and a nuclear study was done for Randomized sample from each group. 12-leads ECG revealed fragmentation of QRS in 74 patients and 146 patients with no QRS fragmentation. Localization of the infarct site revealed NS difference between percentages in both groups. Echocardiography revealed a significant deterioration of LV functions in group-A than group-B. Also, MR jet area was significantly higher in group-A. Coronary angiography revealed severer lesions in group-A more than group-B. Nuclear study revealed higher percentages of irreversible scars in group-A (30%) and higher reversibility in group-B (80%). In-hospital Occurrence of complications from ACS revealed a significant higher incidence of MACE in group-A. Conclusion: Presence of fragmented QRS in surface ECG during ACS represents myocardial scar or fibrosis and reflects the severity of coronary lesions and a correlation between fQRS and depression of LV function is established. Indeed, occurrence of MACE is suspected.

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QRS fragmentation in standard ECG as a diagnostic marker of arrhythmogenic right ventricular dysplasia–cardiomyopathy

Cited by 143 publications

References 8 publications

Fragmented QRS Is Predictive of Myocardial Dysfunction, Pulmonary Hypertension and Severity in Mitral Stenosis

Fragmented QRS Is Predictive of Myocardial Dysfunction, Pulmonary Hypertension and Severity in Mitral Stenosis

Presence of fragmented QRS and its correlation with myocardial performance index in patients with nephrotic syndrome

QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

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