[Fragmented QRS. Relevance in clinical practice].

Area of Science:

• Cardiology
• Electrophysiology
• Medical Diagnostics

Background:

• The QRS complex on an ECG reflects ventricular myocardial depolarization.
• Abnormal electrical conduction can widen the QRS complex, leading to bundle branch blocks or fragmented QRS (fQRS).
• Fragmented QRS is characterized by atypical configurations, including notched R or S waves, not fitting typical bundle branch block patterns.

Purpose of the Study:

• To define fragmented QRS (fQRS) and explore its underlying pathophysiologies.
• To investigate the diagnostic and prognostic relevance of fQRS in various cardiac conditions.

Main Methods:

• Analysis of electrocardiogram (ECG) patterns, specifically focusing on QRS complex morphology.
• Correlation of fQRS findings with underlying cardiac pathologies and patient outcomes.

Main Results:

• Fragmented QRS is associated with a wide range of conditions, including myocardial scars from ischemic heart disease, fibrosis, primary cardiac diseases, and systemic diseases affecting the heart.
• Cellular-level pathologies like ion channel dysfunction are also linked to fQRS.
• fQRS has prognostic value in identifying high-risk patients with coronary artery disease, cardiomyopathy, Brugada syndrome, and acquired long QT syndrome.

Conclusions:

• Fragmented QRS represents a significant finding on ECGs, reflecting diverse cardiac pathologies.
• fQRS possesses both diagnostic and prognostic implications, aiding in risk stratification for various cardiovascular diseases.
• While indicative of potential issues, fQRS can also be present in healthy individuals, necessitating careful interpretation.