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Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing

Sridharan Umapathy1, Rakesh Yadav1, Kewal C Goswami1

  • 1Department of Cardiology, AIIMS, New Delhi, India.

Indian Heart Journal
|January 1, 2019
PubMed

Insights

Fragmented QRS (fQRS) did not predict major adverse cardiac events or LV dysfunction in STEMI patients. However, fQRS independently indicated impaired myocardial reperfusion after revascularization.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Myocardial Infarction Research

Background:

  • Fragmented QRS (fQRS) is a novel electrocardiographic finding.
  • Its prognostic significance in acute ST-elevation myocardial infarction (STEMI) post-revascularization requires further evaluation.

Purpose of the Study:

  • To assess the prognostic value of fQRS in STEMI patients undergoing revascularization.
  • To determine if fQRS predicts major adverse cardiac events (MACE) and left ventricular (LV) dysfunction.
  • To investigate the association between fQRS and myocardial reperfusion.

Main Methods:

  • 103 STEMI patients (Killip class I/II) undergoing primary revascularization were included.
  • ECG for fQRS detection was performed at admission and serially post-PCI.
  • Echocardiography assessed LV function; MACE and ΣSTR (ST segment resolution) were evaluated at 30 days.

Main Results:

  • fQRS was detected in 61.5% of patients, with 57.8% showing persistent fQRS.
  • MACE rates were low and not significantly different between groups.
  • fQRS correlated with LV dysfunction on univariate but not multivariate analysis.
  • fQRS independently predicted impaired microvascular reperfusion (ΣSTR).

Conclusions:

  • fQRS did not predict short-term MACE or LV dysfunction in STEMI patients (Killip I/II).
  • fQRS independently predicted impaired microvascular myocardial reperfusion, suggesting its role in assessing microvascular function post-STEMI.
Abstract

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