Relation of Fragmented QRS Complex to Right Ventricular Fibrosis Detected by Late Gadolinium Enhancement Cardiac Magnetic Resonance in Adults With Repaired Tetralogy of Fallot

Park, Seung‐Jung; On, Young Keun; Kim, June Soo; Park, Seung Woo; Yang, Ji-Hyuk; Jun, Tae-Gook; Kang, I-Seok; Lee, Heung Jae; Choe, Yeon Hyeon; Huh, June

doi:10.1016/j.amjcard.2011.07.070

Cited by 100 publications

(61 citation statements)

References 20 publications

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“…Laterality of fQRS was associated with operative scar of the RV, and patients with fQRS had larger RV volume and lower RV EF. fQRS was closely associated with more extensive RV fibrosis and dysfunction [24]. fQRS was frequent in patients with mitral stenosis caused by rheumatic fever.…”

Section: Congenital and Rheumatic Hdmentioning

confidence: 93%

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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Section: Congenital and Rheumatic Hdmentioning

confidence: 93%

QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

Abdelrahman¹

2013

WJCS

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“…Some investigators have described a relationship between ventricular tachyarrhythmias and right ventricular dilatation due to chronic volume load by means of PR. Furthermore, several ECG parameters, including QRS duration, change rate of QRS duration, QT/JT duration and dispersion, heart rate variability, and fragmented QRS, have been recognized as risk factors for life threatening ventricular arrhythmias and SCD (1,4,6,7,12,13). Residual cardiac lesions or hemodynamic abnormalities are associated with late SCD, including elevated RV pressure due to RVOT obstruction or pulmonary artery stenosis, right ventricular volume load, right ventricular dysfunction, left ventricular longitudinal dysfunction, and left ventricular diastolic dysfunction (5,14).…”

Section: Discussionmentioning

confidence: 99%

Predictors of ventricular tachyarrhythmia occurring late after intracardiac repair of tetralogy of Fallot: combination of QRS duration change rate and tricuspid regurgitation pressure gradient

et al. 2017

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Background: To determine potential predictors of ventricular tachyarrhythmia and sudden cardiac death (SCD) occurring late after repair of tetralogy of Fallot (TOF). Methods: Since 1964, 415 patients had undergone total repair for TOF at Niigata University Hospital. Of these, 89 patients who were followed for more than 10 years at our institute were retrospectively reviewed. Results: The mean follow-up period was 24.3 years. During the study period, one patient died of cerebral bleeding, and two patients had SCD. The overall survival rates at 20, 30, and 40 years were 100%, 94.6%, and 94.6%, respectively. Eight (9.0%) patients required re-intervention during the late period associated with right ventricular outflow (n=4), tricuspid valve (n=3), aortic valve (n=2), and others (n=2). Ten (11.2%) patients had a history of ventricular tachycardia (VT) or ventricular fibrillation (VF), and six underwent implantation of an implantable cardiac defibrillator. Multivariate analysis selected the change rate of QRS duration [ms/year; odds ratio (OR), 2.44; 95% confidence interval (CI): 1.28-4.65; P=0.007] and the pressure gradient at tricuspid valve regurgitation on echocardiography (OR, 1.12; 95% CI: 1.02-1.22; P=0.017) as risk factors for VT/VF or SCD. Trans-annular patch (TAP) repair was not an independent risk factor for ventricular arrhythmia. Conclusions: The combination of rapid change rate of QRS duration and higher-pressure gradient at tricuspid regurgitation were risk factors for ventricular tachyarrhythmia late after TOF repair. Adequate surgical or catheter intervention for pressure and volume load in the right ventricle might decrease the prevalence of VT/VF and SCD.

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“…(4) Bu bulgulara ek olarak godolinyumlu kardiyak manyetik rezonans görüntüleme ile yapılan çalışmalarda fQRS skar alanlarını ön gördürmüştür (16)(17). Diğer çalışmalarda miyokardiyal perfüzyon bozukluğu ve skar dokusu ile fQRS arasında ilişki saptanmıştır (2)(3)(4)(5)18). İlginç bir bulgu olarak koroner arter hastalığı ve dilate kardiyomyopati tanılı ve ventriküler aritmisi olan hastalarda endokardiyal haritalamada skar alanlarının çevresinde fragmante intrakardiyak elektrokardiogramlar alınmış-tır (19)(20).…”

Section: Ekokardioyografi Ve Rutin Tetkiklerunclassified

“…Buna ek olarak manyetik rezonans görüntüleme çalışmaları miyokardiyal skar ve fQRS arasında ilişki saptamıştır (1)(2)(3)(4)(5). Bazı çalışmalarda fQRS kardiyak kötü sonlanımlar ile ilişkili olduğu bulunmuştur (4,(6)(7).…”

Section: Introductionunclassified

The Association Between Fragmeted QRS and ICD Shocks in patients with Left Ventricular Systolic Heart Failure

Özcan¹,

Turak²,

Tok³

et al. 2013

Turk J Bioch

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Amaç: Sol ventrikül sistolik disfonksiyonu olan hastalarda fragmente QRS'in (fQRS) mortalite ve ventriküler aritmi ile ilişkisine dair farklı bilgiler mevcuttur. Biz çalışmamızda fQRS'in fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan implante edilebilir şok cihazı (ICD) taşıyan hasta grubundaki yaşanmış şok olayları ile ilişkisini saptamak istedik.

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Relation of Fragmented QRS Complex to Right Ventricular Fibrosis Detected by Late Gadolinium Enhancement Cardiac Magnetic Resonance in Adults With Repaired Tetralogy of Fallot

Cited by 100 publications

References 20 publications

QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

QRS Fragmentation as a Prognostic Test in Acute Coronary Syndrome

Predictors of ventricular tachyarrhythmia occurring late after intracardiac repair of tetralogy of Fallot: combination of QRS duration change rate and tricuspid regurgitation pressure gradient

The Association Between Fragmeted QRS and ICD Shocks in patients with Left Ventricular Systolic Heart Failure

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