Fragmented QRS complex has poor sensitivity in detecting myocardial scar

Area of Science:

• Cardiology
• Diagnostic Imaging
• Electrocardiography

Background:

• Previous research suggested fragmented QRS on ECG as a sensitive marker for myocardial scar.
• External validation of fragmented QRS for myocardial scar detection was lacking.

Purpose of the Study:

• To assess the association between fragmented QRS complex and Q waves with myocardial scar and viability.
• To validate the utility of fragmented QRS as a marker for myocardial scar.

Main Methods:

• Correlated electrocardiogram (ECG) findings with nuclear perfusion imaging in 460 patients.
• Assessed fragmented QRS and Q waves against myocardial scar detected by perfusion imaging.

Main Results:

• Fragmented QRS was not superior to Q waves in identifying myocardial defects.
• Fragmented QRS demonstrated significantly lower sensitivity (1.7%) versus Q waves (31.7%) for myocardial scar.
• Fragmented QRS showed a higher false positive rate (15.8%) compared to Q waves (1.4%).

Conclusions:

• Both fragmented QRS and Q waves exhibited poor sensitivity and specificity for detecting myocardial scar.
• Larger studies are required to evaluate fragmented QRS as a surrogate for myocardial scar before clinical adoption.