Role of QRS Complex Fragmentation in Patients at High Risk of Cardiovascular Events

Department of Health Sciences’s Investigation, Sanatorio Metropolitano. Fernando de la Mora. Paraguay, Cardiology Department. Clinic Hospital. Asunción National University. San Lorenzo, Paraguay.

Corresponding Author: Osmar Antonio Centurión, Professor of Medicine, Asuncion National University, Department of Health Sciences’s Investigation, Sanatorio Metropolitano, Teniente Ettiene 215 c/ Ruta Mariscal Estigarribia, Fernando de la Mora, Paraguay, 
Tel: 595 21 585 540; E-Mail: [email protected]

Received Date: 28 Dec 2016   
Accepted Date: 10 Jan 2017   
Published Date: 10 Jan 2017

Copyright © 2016 Centurión OA

Citation: Centurión OA, Aquino-Martinez NJ, Torales-Salinas JM, Miño LM, et al. (2017). Role of QRS Complex Fragmentation in Patients at High Risk of Cardiovascular Events. Mathews J Cardiol. 2(1): 009.

ABSTRACT

The presence of fragmented QRS complexes (FQRS) on a routine 12-lead ECG is an interesting marker of depolarization abnormality. There is convincing data suggesting that the FQRS represents conduction delay from inhomogeneous activation of the ventricles due to myocardial scar. However, FQRS is not specific for coronary artery disease and is also encountered in other myocardial diseases such as cardiomyopathy and congenital heart disease. FQRS has also been described in other entities such as arrhythmogenic right ventricular cardiomyopathy and Brugada syndrome. The significance and the predictive value of FQRS complex as an ECG marker of cardiovascular events seem to be different in different entities. In patients with stable coronary artery disease and in patients with acute MI, FQRS seems to be a good predictor of cardiac events. In patients with non-ischemic cardiomyopathy, fragmentation of narrow QRS complex seems to correlate with the degree of fibrosis and dys-synchrony, and importantly may influence the response for cardiac resynchronization therapy. However, based on clinical studies with larger number of patients with current indications for cardiac resynchronization, FQRS does not influence and is not associated with poor response of resynchronization therapy. In patients with LV dysfunction, there is no clear evidence that the presence of FQRS could predict arrhythmic events. On the other hand, there was a statistical significant difference in mortality associated to the presence of fragmented QRS in patients with acute coronary syndrome and myocardial necrosis.

KEYWORDS

QRS Fragmentation; Cardiovascular Events; Electrocardiogram.