Details

Autor(en) / Beteiligte

• Terho, Henri K., BM
• Tikkanen, Jani T., MD
• Junttila, Juhani M., MD
• Anttonen, Olli, MD
• Kenttä, Tuomas V., MSc, PhD
• Aro, Aapo L., MD
• Kerola, Tuomas, MD
• Rissanen, Harri A., MSc
• Reunanen, Antti, MD
• Huikuri, Heikki V., MD

Titel

Prevalence and Prognostic Significance of Fragmented QRS Complex in Middle-Aged Subjects With and Without Clinical or Electrocardiographic Evidence of Cardiac Disease

Ist Teil von

• The American journal of cardiology, 2014-07, Vol.114 (1), p.141-147

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2014

Quelle

ScienceDirect

Beschreibungen/Notizen

• We wanted to evaluate the prevalence and prognostic value of the fragmented QRS (fQRS) complex, defined as changes in QRS morphology with various RSR′-patterns in 12-lead electrocardiogram (ECG) in a middle-aged general population. We evaluated the 12-lead ECGs of 10,904 Finnish middle-aged subjects (52% men, mean age 44 ± 8.5 years) with (n = 2,543) and without (n = 8,361) an evidence of cardiac disease drawn from general population and followed them for 30 ± 11 years. Fragmentation of the QRS complex was defined as various RSR′-patterns in at least 2 consecutive leads within the same territory (inferior II, III, aVF; lateral I, aVL, V4 to V6; anterior V1 to V3). Primary end points were death from any cause, cardiac, and arrhythmic deaths. In the total population, fQRS was present in 19.7% (n = 2,147) of subjects, including 15.7% (n = 1714) in inferior leads, 0.8% (n = 84) in lateral leads, and 2.9% (n = 314) in anterior leads. Fragmentation was not associated with increased mortality in subjects without a known cardiac disease. However, fQRS observed in lateral leads in subjects with an evidence of cardiac disease was associated with an increased risk of all-cause (p = 0.001), cardiac (p = 0.001), and arrhythmic (p = 0.004) mortalities. In conclusion, fQRS reflecting minor intraventricular conduction defect is a common finding, especially in the inferior leads, but it is not a sign of increased risk of mortality in subjects without a known cardiac disease. Lateral fQRS, which is less commonly observed in the ECG, is associated with a worse outcome in patients with a known cardiac disease.