Fragmented QRS and other depolarization abnormalities as a predictor of mortality and sudden cardiac death

Current Opinion in Cardiology

Volumn 25, Issue 1, 2010, Pages 59-64

  Das, Mithilesh K ^a   El Masry, Hicham ^a  

^a INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Arrhythmic events; Fragmented QRS; Mortality

Indexed keywords

ARRHYTHMOGENESIS; BRUGADA SYNDROME; CAUSE OF DEATH; CORONARY ARTERY DISEASE; DISEASE MARKER; ELECTROCARDIOGRAPHY MONITORING; HEART DEATH; HEART DEPOLARIZATION; HEART LEFT BUNDLE BRANCH BLOCK; HEART RIGHT BUNDLE BRANCH BLOCK; HEART RIGHT VENTRICLE DYSPLASIA; HUMAN; MAGNETOCARDIOGRAPHY; MORTALITY; PREDICTION; PRIORITY JOURNAL; QRS COMPLEX; REVIEW; RISK ASSESSMENT; RISK FACTOR; SUDDEN DEATH; T WAVE;

ARRHYTHMIAS, CARDIAC; DEATH, SUDDEN, CARDIAC; ELECTROCARDIOGRAM PATTERN; HUMANS; MAGNETOCARDIOGRAPHY; PREDICTIVE VALUE OF TESTS; RISK FACTORS;

EID: 74249087861     PISSN: 02684705     EISSN: None     Source Type: Journal    
DOI: 10.1097/HCO.0b013e328333d35d     Document Type: Review

References (33)

1. Zipes DP, Wellens HJ. Sudden cardiac death. Circulation 1998; 98:2334-2351.
2. Goldberger JJ, Cain ME, Hohnloser SH, et al. American Heart Association/ American College of Cardiology Foundation/Heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. Heart Rhythm 2008; 5:e1-e21.
3. Huikuri HV, Castellanos A, Myerburg RJ. Sudden death due to cardiac arrhythmias. N Engl J Med 2001; 345:1473-1482.
4. 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; 113:2495-2501.
5. Peters S, Trümmel M, Koehler B. QRS fragmentation in standard ECG as a diagnostic marker of arrhythmogenic right ventricular dysplasia- cardiomyopathy. Heart Rhythm 2008; 5:1417-1421.
6. Morita H, Kusano KF, Miura D, et al. Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome. Circulation 2008; 118:1697-1704.
7. Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12-lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease. Heart Rhythm 2007; 4:1385-1392.
8. 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 Arrhythmia Electrophysiol 2008; 1:258-268.
9. Pietrasik G, Goldenberg I, Zdzienicka J, et al. Prognostic significance of fragmented QRS complex for predicting the risk of recurrent cardiac events in patients with Q-wave myocardial infarction. Am J Cardiol 2007; 100:583-586.
10. Maskoun W, Suradi H, Mahenthiran J, et al. Fragmented QRS complexes on a 12-lead ECG predict arrhythmic events in patients with ischemic cardiomyopathy who receive an ICD for primary prophylaxis. Heart Rhythm 2007; 4:S211-S212.
11. Maehara K, Kokubun T, Awano N, et al. Detection of abnormal high-frequency components in the QRS complex by the wavelet transform in patients with idiopathic dilated cardiomyopathy. Jpn Circ J 1999; 63:25-32.
12. Homsi M, Alsayed L, Das MK, Mahenthiran J. Fragmented QRS complexes on a 12-lead ECG is a marker of greater myocardial scarring related to noncoronary artery diseases by magnetic resonance imaging. J Am Coll Cardiol 2009; 53 (10S):A140.
13. Michael M, Das M. Fragmented QRS (fQRS) on 12-lead EKG is a predictor of arrhythmic events and mortality in patients with dilated cardiomyopathy [abstract #50-2]. Heart Rhythm 2006; 3:S103.
14. Ellenbogen KA, Levine JH, Berger RD, et al. Are implantable cardioverter defibrillator shocks a surrogate for sudden cardiac death in patients with nonischemic cardiomyopathy? Circulation 2006; 113:776-782.
15. Kanda M, Shimizu W, Matsuo K, et al. Electrophysiologic characteristics and implications of induced ventricular fibrillation in symptomatic patients with Brugada syndrome. J Am Coll Cardiol 2002; 39:1799-1805.
16. Postema P, Tan H, Dekker L, et al. Right ventricular endocardial mapping in Brugada syndrome patients reveals cooperative depolarization and repolarization abnormalities. Circulation 2007; 116:490-491.
17. Wiener I, Mindich B, Pitchon R. Fragmented endocardial electrical activity in patients with ventricular tachycardia: a new guide to surgical therapy. Am Heart J 1984; 107:86-90.
18. Hisamatsu K, Kusano KF, Morita H, et al. Relationships between depolarization abnormality and repolarization abnormality in patients with Brugada syndrome: using body surface signal-averaged electrocardiography and body surface maps. J Cardiovasc Electrophysiol 2004; 15:870-876.
19. Morita H, Takenaka-Morita S, Fukushima-Kusano K, et al. Risk stratification for asymptomatic patients with Brugada syndrome. Circ J 2003; 67:312-316.
20. Nagase S, Kusano KF, Morita H, et al. Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome: using the epicardial lead. J Am Coll Cardiol 2002; 39:1992-1995.
21. Kusmirek SL, Gold MR. Sudden cardiac death: the role of risk stratification. Am Heart J 2007; 153 (4 Suppl):25-33.
22. Gomes JA, Cain ME, Buxton AE, et al. Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction. Circulation 2001; 104:436-441.
23. Korhonen P, Husa T, Tierala I, et al. Increased intra-QRS fragmentation in magnetocardiography as a predictor of arrhythmic events and mortality in patients with cardiac dysfunction after myocardial infarction. J Cardiovasc Electrophysiol 2006; 17:396-401.
24. Flowers NC, Horan LG, Thomas JR, Tolleson WJ. The anatomic basis for highfrequency components in the electrocardiogram. Circulation 1969; 39:531-539.
25. Varriale P, Chryssos BE. The RSR' complex not related to right bundle branch block: diagnostic value as a sign of myocardial infarction scar. Am Heart J 1992; 123:369-376.
26. Mahenthiran J, Khan BR, Sawada SG, Das MK. Fragmented QRS complexes not typical of a bundle branch block: a marker of greater myocardial perfusion tomography abnormalities in coronary artery disease. J Nucl Cardiol 2007; 14:347-353.
27. Flowers NC, Horan LG, Wylds AC, et al. Relation of peri-infarction block to ventricular late potentials in patients with inferior wall myocardial infarction. Am J Cardiol 1990; 66:568-574.
28. Gardner PI, Ursell PC, Fenoglio JJ Jr, Wit AL. Electrophysiologic and anatomic basis for fractionated electrograms recorded from healed myocardial infarcts. Circulation 1985; 72:596-611.
29. Friedman BM, Dunn MI. Postinfarction ventricular aneurysms. Clin Cardiol 1995; 18:505-511.
30. Stevenson WG, Soejima K. Catheter ablation for ventricular tachycardia. Circulation 2007; 115:2750-2760.
31. de Bakker JM, van Capelle FJ, Janse MJ, et al. Slow conduction in the infarcted human heart. 'Zigzag' course of activation. Circulation 1993; 88:915-926.
32. de Bakker JM, van Capelle FJ, Janse MJ, et al. Fractionated electrograms in dilated cardiomyopathy: origin and relation to abnormal conduction. J Am Coll Cardiol 1996; 27:1071-1078.
33. Langner PH Jr, Geselowitz DB, Briller SA. Wide band recording of the electrocardiogram and coronary heart disease. Am Heart J 1973; 86: 308-317.