| Fragmented left sided QRS in absence of bundle branch block: sign of left ventricular aneurysm. | |
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MedLine Citation:
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PMID: 16630087 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: A left ventricular aneurysm (LVA) occurs between 3.5% and 9.4% of all cases of acute myocardial infarction. A fragmented left sided QRS (RSR; pattern or its variant RSr;, rSR;, or rSr;) without evidence of bundle branch block (QRS duration <or=120 ms) on the ECG may be associated with a significant myocardial scar, which is the characteristic of a LVA. We, therefore, postulate that fragmented QRS (RSR; pattern or its variant) in the left sided leads (I, aVL, V(3) to V(6)) may be a useful sign of LVA. METHODS: ECGs of 110 consecutive patients with LVA documented by left ventricular angiography (30 degrees right anterior oblique view) was compared with 220 patients without LVA (110 patients with and 110 patients without coronary artery disease (CAD)), who were evaluated for CAD by symptoms and signs. RESULTS: The sensitivity of the fragmented QRS for identification of LVA was 50% (55 of 110 patients) and specificity was 94.6% (209 of 220). Within the study population, the positive predictive value of the fragmented QRS for LVA was 83.3% (55 of 66) and the negative predictive value was 79.2% (209 of 264). Based on the range of prevalence of LVA in postmyocardial infarction population (3.5-9.4%) and on observed sensitivity and specificity, the positive predictive value of fragmented QRS for LVA after infarction can be estimated at 29-53% and the negative predictive value can be estimated at 95-98%. CONCLUSION: The sensitivity of fragmented QRS in left precordial leads for LVA was only 50%, whereas the specificity was 94.5%. It has a relatively low to moderate positive predictive value and high negative predictive value. |
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Authors:
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Chatla V R Reddy; Kuruvilla Cheriparambill; Barry Saul; Majesh Makan; John Kassotis; Awaneesh Kumar; Mithilesh Kumar Das |
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Publication Detail:
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Type: Comparative Study; 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: 11 ISSN: 1082-720X ISO Abbreviation: Ann Noninvasive Electrocardiol Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-24 Completed Date: 2006-06-02 Revised Date: 2008-03-10 |
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: 132-8 Citation Subset: IM |
Affiliation:
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New York Methodist Hospital, New York , USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block Electrocardiography* Female Heart Aneurysm / diagnosis*, physiopathology Humans Male Predictive Value of Tests Sensitivity and Specificity Ventricular Dysfunction, Left / diagnosis*, physiopathology |
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