Prevalence and Most Commonly Encountered QRS Fragmentation Morphology and Early Repolarization ST-Segment Changes
Khalid Sawalha1,2, Robert F Spraggins Ii3, Munes Albadaineh1
1Cardiovascular Disease, University of Arkansas for Medical Sciences, Little Rock, USA.
Background:
SARS-CoV-2 infection has been shown to cause instability of myocardial cell membranes through different mechanisms. This instability can manifest as fragmented QRS (fQRS) complexes and early repolarization (ER) on an electrocardiogram (ECG). Since ECG abnormalities during this pandemic have not been previously reported, we investigated the prevalence of fQRS and ER during the height of the COVID-19 pandemic at our institution involving two hospitals.
Methods:
A total of 1,476 ECG tracings obtained between December 2020 and March 2021 at University Health-Truman Medical Centers were retrospectively reviewed by a single cardiologist. Current and prior tracings were analyzed for ER changes, and fQRS was identified using the traditional Das criteria. Patients were further stratified by age, race, and gender.
Results:
Of the 1,476 patients, 570 (39%) had fQRS and 68 (4.6%) had ER changes. Respective demographics, associated rhythms, and presence of left ventricular hypertrophy were also reported. Among patients with fQRS, we report the most common ECG lead locations and morphologies.
Conclusion:
In our single-institution study, ECGs obtained during the peak of the COVID-19 pandemic showed a prevalence of 39% for fQRS and 4.6% for ER. While the prevalence of ER was comparable to that observed in the general population, newly identified fQRS was observed at a substantially higher frequency than has been reported in healthy adult populations.
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