| Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. | |
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MedLine Citation:
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PMID: 17954396 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) is associated with myocardial scar in patients with coronary artery disease (CAD). OBJECTIVE: We postulated that fQRS is a predictor of cardiac events and mortality in patients who have known CAD or who are being evaluated for CAD. METHODS: The cardiac events (myocardial infarction, need for revascularization, or cardiac death) and all-cause mortality were retrospectively reviewed in 998 patients (mean age 65.5 +/- 11.9 years, male 967) who underwent nuclear stress test. The fQRS on a 12-lead ECG included various RSR' patterns (> or =1 R' prime or notching of S wave or R wave) without typical bundle branch block in 2 contiguous leads corresponding to a major coronary artery territory. RESULTS: All-cause mortality (93 [34.1%] vs 188 [25.9%]) and cardiac event rate (135 [49.5%] vs 200 [27.6%]) were higher in the fQRS group compared with the non-fQRS group during a mean follow-up of 57 +/- 23 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events (P <.001) and all-cause mortality (P = .02). Multivariate Cox regression analysis revealed that significant fQRS was an independent significant predictor for cardiac events but not for all-cause mortality. The Kaplan-Meier survival analysis showed no significant difference between fQRS and Q waves groups for cardiac events (P = .48) and all-cause mortality (P = .08). CONCLUSION: The fQRS is an independent predictor of cardiac events in patients with CAD. It is associated with significantly lower event-free survival for a cardiac event on long-term follow-up. |
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Authors:
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Mithilesh Kumar Das; Chandan Saha; Hicham El Masry; Jonathan Peng; Gopi Dandamudi; Jo Mahenthiran; Paul McHenry; Douglas P Zipes |
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Publication Detail:
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Type: Journal Article Date: 2007-08-01 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 4 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-10-23 Completed Date: 2008-02-08 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 1385-92 Citation Subset: IM |
Affiliation:
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Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. midas@iupui.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Artery Disease / diagnosis*, mortality Electrocardiography* Exercise Test Female Humans Male Prognosis Retrospective Studies Risk Factors Stroke Volume Tomography, Emission-Computed, Single-Photon |
| Comments/Corrections | |
Comment In:
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Heart Rhythm. 2007 Nov;4(11):1393-4
[PMID:
17954397
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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