Observational studyJournal of the American Heart Association2015
QRS fragmentation and sudden cardiac death in the obese and overweight.
Observational study in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 40 citations in OpenAlex.
- Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion.Obesity surgery · 2018Trial
- Developing cardiac digital twin populations powered by machine learning provides electrophysiological insights in conduction and repolarization.Nature cardiovascular research · 2025Article
- Physiological Changes in QRS Fragmentation in Athletes and Nonathletes without Cardiac Disease.Journal of clinical medicine · 2024Article
- The Fragmented QRS Complex in Lead VJournal of cardiovascular translational research · 2024Article
- The value of the 12-lead electrocardiogram in the prediction of sudden cardiac death.European heart journal supplements : journal of the European Society of Cardiology · 2023Article
- QRS Fragmentation in Preserved Ejection Fraction Heart Failure: Functional Insights, Pathological Correlates, and Prognosis.Journal of the American Heart Association · 2023Article
- Eosinophilic Infiltration of the Sino-Atrial Node in Sudden Cardiac Death Caused by Long QT Syndrome.International journal of molecular sciences · 2022Article
- Obesity in young sudden cardiac death: Rates, clinical features, and insights into people with body mass index >50kg/mAmerican journal of preventive cardiology · 2022Article
- The Impact of Obesity on Sudden Cardiac Death Risk.Current cardiology reports · 2022Review
- Obesity and sudden cardiac death: Prevalence, pathogenesis, prevention and intervention.Frontiers in cell and developmental biology · 2022Review
- Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association.Circulation · 2021Review
- Electrocardiographic Characteristics of Breast Cancer Patients Treated with Chemotherapy.Cardiology research and practice · 2020Article
- Arrhythmias and Sudden Cardiac Death in Beta-Thalassemia Major Patients: Noninvasive Diagnostic Tools and Early Markers.Cardiology research and practice · 2019Review
- High-Fat-Diet-Induced Obesity Produces Spontaneous Ventricular Arrhythmias and Increases the Activity of Ryanodine Receptors in Mice.International journal of molecular sciences · 2018Article
- Anaesthetic Preparation of Obese Patients: Current Status on Optimal Work-up.Current obesity reports · 2017Review
- The ReCaPTa study - a prospective out of hospital cardiac arrest registry including multiple sources of surveillance for the study of sudden cardiac death in the Mediterranean area.Scandinavian journal of trauma, resuscitation and emergency medicine · 2016Review
- Total Mortality, Major Adverse Cardiac Events, and Echocardiographic-Derived Cardiac Parameters with Fragmented QRS Complex.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2016Review
- Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundObesity has been associated with significantly greater risk of sudden cardiac death (SCD); however, identifying the obese patient at highest risk remains a challenge. We evaluated the association between QRS fragmentation on the 12-lead electrocardiogram and SCD, in obese/overweight subjects. METHODS AND
resultsIn the ongoing prospective, community-based Oregon Sudden Unexpected Death Study (population approximately 1 million), we performed a case-control analysis, comparing obese/overweight SCD victims with obese/overweight controls from the same geographic region. Archived ECGs prior and unrelated to the SCD event were used for cases and all ECG measurements were assessed in blinded fashion. Fragmentation was defined as the presence of RSR' patterns and/or notching of the R/S wave in at least 2 contiguous leads. Analysis was limited to ECGs with QRS duration <120 ms. Overall prevalence of fragmentation was higher in cases (n=185; 64.9±13.8 years; 67.0% male) compared with controls (n=405; 64.9±11.0 years; 64.7% male) (34.6% versus 26.9%, P=0.06). Lateral fragmentation was significantly more frequent in cases (8.1% versus 2.5%; P<0. 01), with non-significant differences in anterior and inferior territories. Fragmentation in multiple territories (≥2) was also more likely to be observed in cases (9.7% versus 4.9%, P=0.02). In multivariable analysis with consideration of established SCD risk factors, lateral fragmentation was significantly associated with SCD (OR 2.84; 95% CI 1.01 to 8.02; P=0.05).
conclusionQRS fragmentation, especially in the lateral territory is a potential risk marker for SCD independent of the ejection fraction, among obese/overweight subjects in the general population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.