Document Detail


Fragmented QRS complex has poor sensitivity in detecting myocardial scar.
MedLine Citation:
PMID:  20946552     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To study the association of the fragmented QRS complex versus the Q wave with myocardial scar and viability.
BACKGROUND: A prior study has suggested that the fragmented QRS complex on an electrocardiogram (ECG) is a highly sensitive and specific marker of myocardial scar as detected by regional perfusion abnormalities on a nuclear stress test. There is no external validation of this data.
METHODS: We correlated the ECG and nuclear perfusion images of 460 consecutive patients with known or suspected coronary artery disease. The presence of fragmented QRS or Q waves in two contiguous ECG leads was correlated with major coronary artery distributions on nuclear perfusion imaging.
RESULTS: For the 1842 evaluated territories, the fragmented QRS complex was not superior to the Q wave in detecting fixed or mixed myocardial defects. The fragmented QRS complex was associated with worse sensitivity (1.7%) in comparison to the Q wave (31.7%) for identifying myocardial scar. The fragmented QRS complex carried a higher false positive rate in patients with normal perfusion scans (15.8%, 221 segments), in comparison to Q waves (1.4%, 17 segments).
CONCLUSION: In our study population, both the fragmented QRS and Q wave had poor sensitivity and specificity in detecting fixed or mixed myocardial scar. Larger studies are needed to evaluate fragmented QRS as a surrogate of myocardial scar before it can be incorporated into clinical practice.
Authors:
Dee Dee Wang; Daniel M Buerkel; James R Corbett; Hitinder S Gurm
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  15     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  308-14     Citation Subset:  IM    
Copyright Information:
©2010, Wiley Periodicals, Inc.
Affiliation:
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA. dwang2@hfhs.org
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