Document Detail


The fragmented QRS: does it really indicate a ventricular abnormality?
MedLine Citation:
PMID:  20543708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Notching of R and S waves in the QRS complex can result from myocardial infarction. As defined in recent studies, the 'fragmented QRS' (fQRS) showed high sensitivity and specificity for the presence of myocardial scar as imaged by myocardial perfusion scanning in participants studied for ischemic heart disease. The present study attempted to determine the significance of the fQRS in electrocardiograms of patients who had myocardial imaging for a variety of reasons by a variety of methods.
METHODS: From a series of electrocardiograms, 218 patients were found with fQRS without abnormal Q waves, but with myocardial imaging by myocardial perfusion scanning or echocardiography. Another 214 patients without fQRS but having had one of these imaging methods were also studied. An additional 106 patients with or without fQRS were selected for having undergone cardiac magnetic resonance imaging with studies for late gadolinium enhancement.
RESULTS: Myocardial perfusion scanning, echocardiography, or magnetic resonance imaging revealed a ventricular myocardial abnormality in 52.6% of patients with fQRS and in 29.7% without fQRS (P < 0.0001). Ischemic heart disease was present in only 27% of patients showing fQRS. An electrocardiographic point score system was devised that helped to differentiate tracings having an fQRS with a ventricular abnormality from those without the latter.
CONCLUSION: The utility of fQRS varies with the incidence of ventricular disease in the population studied. This electrocardiographic sign is commonly associated with ventricular abnormalities with and without demonstrable myocardial scar, but also occurs in the absence of clinical heart disease.
Authors:
Rex N MacAlpin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  801-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, California 90095-1679, USA. rex.macalpin@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chi-Square Distribution
Echocardiography, Doppler
Electrocardiography*
Female
Heart Diseases / diagnosis*,  pathology,  physiopathology
Heart Ventricles / pathology,  physiopathology*
Humans
Los Angeles
Magnetic Resonance Imaging
Male
Middle Aged
Myocardial Contraction
Myocardial Perfusion Imaging
Myocardium / pathology
Predictive Value of Tests
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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