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Fragmented QRS complex in patients with implantable cardioverter defibrillator-Prevalence and predisposing factors

Anna Kucharz1, Piotr Kułakowski2

  • 1Department of Cardiology, Saint Vincent a Paulo Hospital, 81-348 Gdynia, ul. Wójta Radtkego 1, Poland.

Journal of Electrocardiology
|September 5, 2018
PubMed

Insights

Fragmented QRS (fQRS) is common in implantable cardioverter-defibrillator patients with coronary artery disease. Fragmented QRS can help identify the location of coronary artery disease non-invasively.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Fragmented QRS (fQRS) incidence and contributing factors in implantable cardioverter-defibrillator (ICD) patients are not well-established.
  • Coronary artery disease (CAD) is a common comorbidity in ICD patients.
  • Understanding fQRS in this population is crucial for risk stratification and management.

Purpose of the Study:

  • To determine the incidence of fQRS in patients with ICD.
  • To identify factors associated with fQRS in this cohort.
  • To evaluate the predictive value of fQRS for identifying the site of CAD.

Main Methods:

  • Retrospective analysis of demographic, clinical, and electrocardiogram (ECG) data.
  • Inclusion of consecutive patients implanted with an ICD.
  • Assessment of fQRS presence and its correlation with clinical and ECG parameters.

Main Results:

  • Fragmented QRS (fQRS) was present in 43% of 382 ICD patients.
  • fQRS was associated with a history of myocardial infarction (MI), Q waves, reduced left ventricular ejection fraction, and prolonged repolarization.
  • Combining fQRS with Q wave location accurately predicted the site of CAD (84-95% accuracy).

Conclusions:

  • Fragmented QRS (fQRS) is prevalent in ICD patients, particularly those with CAD and advanced cardiac disease.
  • fQRS may serve as a valuable ECG marker for non-invasive identification of CAD location.
  • Further research can explore the integration of fQRS into clinical decision-making for ICD patients.
Abstract

Keywords:
Fragmented QRSImplantable cardioverter-defibrillatorQ wave

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