| Fragmented QRS complex has poor sensitivity in detecting myocardial scar. | |
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MedLine Citation:
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PMID: 20946552 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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Dee Dee Wang; Daniel M Buerkel; James R Corbett; Hitinder S Gurm |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2010-10-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9607443 Medline TA: Ann Noninvasive Electrocardiol Country: United States |
Other Details:
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Languages: eng Pagination: 308-14 Citation Subset: IM |
Copyright Information:
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©2010, Wiley Periodicals, Inc. |
Affiliation:
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Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA. dwang2@hfhs.org |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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