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. 2009 Oct;14(4):319-26.
doi: 10.1111/j.1542-474X.2009.00320.x.

Fragmented QRS complexes on 12-lead ECG: a marker of cardiac sarcoidosis as detected by gadolinium cardiac magnetic resonance imaging

Mohamed Homsi  1 , Lamaan Alsayed, Bilal Safadi, Jo Mahenthiran, Mithilesh K Das
Affiliations

Fragmented QRS complexes on 12-lead ECG: a marker of cardiac sarcoidosis as detected by gadolinium cardiac magnetic resonance imaging

Mohamed Homsi et al. Ann Noninvasive Electrocardiol. 2009 Oct.

Abstract

Background: Fragmented QRS complexes (fQRS) on a 12-lead ECG are a marker of myocardial scar in patients with coronary artery disease. Cardiac sarcoidosis is also associated with myocardial granuloma formation and scarring. We evaluated the significance of fQRS on a 12-lead ECG compared to Gadolinium-delayed enhancement images (GDE) in cardiac magnetic resonance imaging (CMR).

Method and results: The ECGs of patients (n = 17, mean age: 52 +/- 11 years, male: 53%) with established diagnosis of sarcoidosis who underwent a CMR for evaluation of cardiac involvement were studied. ECG abnormalities included bundle branch block, Q wave, and fQRS. fQRS, Q wave, and bundle branch block were present in 9 (53%), 1 (6%), and 4 (24%) patients, respectively. The sensitivity and specificity of fQRS for detecting abnormal GDE were 100% and 80%, respectively. Sensitivity and specificity of Q waves were 11% and 100%, respectively.

Conclusions: fQRS on a 12-lead ECG in patients with suspected cardiac sarcoidosis are associated with cardiac involvement as detected by GDE on CMR.

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Figures

Figure 1
Figure 1
Different morphologies of fragmented QRS on a 12‐lead ECG.
Figure 2
Figure 2
Example of sarcoidosis patient with fragmented QRS complex on 12‐lead ECG and CMR abnormalities concerning for cardiac involvement of sarcoidosis.
Figure 3
Figure 3
Myocardial biopsy from the apex showing nonnecrotizing granulomas composed of epithelioid histiocytes and giant cells consistent with myocardial sarcoidosis.
See this image and copyright information in PMC

References

    1. Matsui Y, Iwai K, Tachibana T, et al Clinicopathological study of fatal myocardial sarcoidosis. Ann NY Acad Sci 1976;278:455–469. - PubMed
    1. Roberts WC, McAllister HA Jr., Ferrans VJ. Sarcoidosis of the heart. A clinicopathologic study of 35 necropsy patients (group 1) and review of 78 previously described necropsy patients (group 11). Am J Med 1977;63:86–108. - PubMed
    1. Sharma OP, Maheshwari A, Thaker K. Myocardial sarcoidosis. Chest 1993;103:253–258. - PubMed
    1. Silverman KJ, Hutchins GM, Bulkley BH. Cardiac sarcoid: A clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation 1978;58:1204–1211. - PubMed
    1. Uemura A, Morimoto S, Hiramitsu S, et al Histologic diagnostic rate of cardiac sarcoidosis: Evaluation of endomyocardial biopsies. Am Heart J 1999;138:299–302. - PubMed