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Fragmented ECG as a risk marker in cardiovascular diseases

Rahul Jain, Robin Singh, Sundermurthy Yamini

  • 1Krannert Institute of Cardiology, Indiana University Health, 1800 North Capitol Avenue, Indianapolis, IN 46202, USA. midas@iupui.edu.

Current Cardiology Reviews
|May 16, 2014
PubMed

Insights

Fragmented QRS complexes (fQRS) on an ECG can indicate ventricular depolarization abnormalities and myocardial scarring. While fQRS shows high predictive value for mortality and arrhythmias in various heart conditions, its interpretation requires clinical context.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Noninvasive tests for sudden cardiac death (SCD) risk stratification often have low positive predictive value, especially in structural heart disease.
  • Fragmented QRS complexes (fQRS) on a 12-lead ECG signal depolarization abnormalities and are linked to myocardial scar.

Purpose of the Study:

  • To evaluate the prognostic significance of fQRS in various cardiac conditions.
  • To assess the role of fQRS as a marker for sudden cardiac death risk.

Main Methods:

  • Analysis of 12-lead ECGs to identify fQRS morphology.
  • Correlation of fQRS findings with clinical data, including myocardial scar, mortality, and arrhythmic events.
  • Study populations included patients with coronary artery disease (CAD), cardiomyopathy, and other specific heart conditions.

Main Results:

  • fQRS demonstrates a high predictive value for myocardial scar and mortality in patients with CAD.
  • fQRS is associated with increased risk of arrhythmic events and mortality in patients with implantable cardioverter defibrillators.
  • fQRS indicates a poor prognosis in nonischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, and Brugada syndrome.

Conclusions:

  • fQRS is a valuable, albeit nonspecific, marker for identifying patients at risk of sudden cardiac death.
  • The diagnostic and prognostic utility of fQRS is enhanced when interpreted alongside clinical evidence and the specific type of myocardial involvement.

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