Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul;16(3):270-5.
doi: 10.1111/j.1542-474X.2011.00442.x.

Fragmented QRS is associated with all-cause mortality and ventricular arrhythmias in patient with idiopathic dilated cardiomyopathy

Jing Sha  1 , Shu Zhang, Min Tang, Keping Chen, Xinran Zhao, Fangzheng Wang
Affiliations

Fragmented QRS is associated with all-cause mortality and ventricular arrhythmias in patient with idiopathic dilated cardiomyopathy

Jing Sha et al. Ann Noninvasive Electrocardiol. 2011 Jul.

Abstract

Background: Several studies have showed that fragmented QRS complexes (f - QRS, defined as different RSR' patterns) on a routine 12 - lead electrocardiogram were associated with increased mortality and arrhythmic events in patients with coronary artery disease, but relatively little data were available regarding idiopathic dilated cardiomyopathy (IDCM).

Objective: The purpose of this study was to evaluate the relationship between fragmentation of QRS and the combined end point of all-cause mortality and ventricular arrhythmias in patients with IDCM.

Methods: One hundred twenty-eight patients with IDCM and left ventricular dysfunction (ejection fraction, EF ≤ 40%) were analyzed, respectively. According to QRS duration and the existence of f - QRS on 12-lead electrocardiograph (ECG), the study populations were divided into three groups: (1) the f - QRS group (QRS <120 ms and with fragmented QRS, n = 51), (2) the wide QRS (wQRS) group (QRS ≥ 120 ms, n = 48), and (3) the nonfragmented QRS (non-fQRS) group (QRS < 120 ms and without f - QRS, n = 29).

Results: During a mean follow-up of 14 ± 5 months, 25 (19.5%) patients had deaths and ventricular arrhythmic events. The combined end point of all-cause mortality and ventricular tachyarrhythmias was significantly higher in the f - QRS and wQRS groups than the non-fQRS group (23.5%, 25%, and 3.4%, respectively; P < 0.05 for both). Event-free was significantly decreased in the f - QRS group versus the non-fQRS group (P = 0.02). Univaritae regression analysis revealed that f - QRS was a stronger predictor of mortality and arrhythmic events in IDCM patients.

Conclusion: f - QRS on 12-lead ECG has a high predictive value for the combined end point of all-cause mortality and ventricular tachyarrhythmias in IDCM patients with left ventricular dysfunction.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan‐Meier analysis for the combined end point of all‐cause mortality and ventricular tachyarrhythmia in patients with fragmented QRS (the f ‐ QRS group), wide QRS (the wQRS group), and nonfragmented QRS (the non‐fQRS group).
See this image and copyright information in PMC

References

    1. Huikuri HV, Makikallio TH, Raatikainen MJ, et al Prediction of sudden cardiac death: Appraisal of the studies and methods assessing the risk of sudden arrhythmic death. Circulation 2003;108:110–115. - PubMed
    1. Das MK, Suradi H, Maskoun W, et al Fragmented wide QRS on a 12‐lead ECG: A sign of myocardial scar and poor prognosis. Circ Arrhythm Electrophysiol 2008;1(4):258–268. - PubMed
    1. Das MK, Zipes DP. Fragmented QRS: Apredictor of mortality and sudden cardiac death. Heart Rhythm 2009;6(3 Suppl):S8–S14. - PubMed
    1. Das MK, El Masry H. Fragmented QRS and other depolarization abnormalities as a predictor of mortality and sudden cardiac death. Curr Opin Cardiol 2010 Jan;25(1):59–64. - PubMed
    1. Das MK, Khan B, Jacob S, et al Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease. Circulation 2006;113:495–2501. - PubMed

MeSH terms