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The Fragmented QRS Complex in Lead V1: Time for an Update of the Athlete's ECG?

Marco Vecchiato1, Giulia Quinto1, Nicola Borasio1

  • 1Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padua, Italy.

Journal of Cardiovascular Translational Research
|October 31, 2023
PubMed

Insights

Fragmented QRS in lead V1 (fQRSV1) is common in young athletes, linked to training adaptations. This ECG finding does not predict exercise-induced arrhythmias, even in highly trained individuals.

Area of Science:

  • Sports Cardiology
  • Cardiovascular Physiology
  • Electrocardiography

Background:

  • Distinguishing athlete's heart from pathology using ECG is challenging.
  • The role of fragmented QRS in athletes is not well understood.

Purpose of the Study:

  • To evaluate fragmented QRS in lead V1 (fQRSV1) in young athletes.
  • To determine the association between fQRSV1 and cardiac adaptations and arrhythmias.

Main Methods:

  • Retrospective analysis of 684 young athletes undergoing pre-participation screening.
  • Maximal exercise testing and transthoracic echocardiography were performed.
  • Prevalence of fQRSV1 and its correlation with cardiac parameters and arrhythmias were assessed.

Main Results:

  • fQRSV1 was present in 33% of young athletes.
  • fQRSV1 correlated with higher exercise capacity, right ventricular function/remodeling, and left ventricular wall thickness in highly trained athletes.
  • No association was found between fQRSV1 and exercise-induced arrhythmias.

Conclusions:

  • fQRSV1 in young athletes is associated with training-induced cardiac adaptations.
  • fQRSV1 is not a predictor of exercise-induced ventricular arrhythmias in this population.

Keywords:
Athlete’s heartExercise testingQRS fragmentationRight ventricleSportsVentricular arrhythmias

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