ArticleAnatolian journal of cardiology2016
Significance of a fragmented QRS complex in patients with chronic total occlusion of coronary artery without prior myocardial infarction.
Article in Anatolian journal of cardiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Baseline fragmented QRS is associated with increased all-cause mortality in heart failure with reduced ejection fraction: A systematic review and meta-analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2019Pooled it
- Development of rapid evaluation scale for pericardiectomy of tuberculous constrictive pericarditis by 12-lead electrocardiogram.Journal of cardiothoracic surgery · 2025Article
- Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle-tracking echocardiographic study.Journal of arrhythmia · 2020Article
- Abnormal ECG Findings in Athletes: Clinical Evaluation and Considerations.Current treatment options in cardiovascular medicine · 2019Review
- QRS Fragmentation Patterns Representing Myocardial Scar Need to Be Separated from Benign Normal Variants: Hypotheses and Proposal for Morphology based Classification.Frontiers in physiology · 2016Article
- Fragmented QRS - Its significance.Indian pacing and electrophysiology journalReview
- Investigation of short-term prognosis of fragmented QRS complexes in patients with acute myocardial infarction in two groups that received invasive and fibrinolytic therapy.Indian heart journalArticle
- Application and clinical significance of tissue ultrasound for assessment of right ventricular diastolic function in patients with coronary slow flow.Pakistan journal of medical sciencesArticle
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Authors and funding
8 authors.
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Abstract
objectiveFragmented QRS (fQRS) complexes that have numerous RSR´ patterns represent alteration of ventricular depolarization. We evaluated the relationship between fQRS and poor coronary collateral circulation and the diagnostic ability of fQRS for myocardial scar detection in patients with chronic total occlusion (CTO) without a history of myocardial infarction.
methodsThe study population consisted of patients undergoing coronary angiography with a suspicion of CAD. Seventy-nine patients with one totally occluded major coronary artery were enrolled. Exclusion criteria were history of MI; recent acute coronary syndrome; pathologic Q wave on 12-lead ECG; cardiomyopathy or severe valvular disease; coronary artery bypass surgery or percutaneous coronary angioplasty. Collateral circulation was scored on the basis of Rentrop's classification. All patients were assessed by myocardial perfusion SPECT. Fragmented QRS was characterized as existence of an R´ or R wave or S wave notch in two adjacent leads related to the location of a major coronary artery region. Single and multiple logistic regression analyses were completed in the forward method.
resultsForty-nine patients had poor and 30 had well-developed collateral circulation. Fragmented QRS complexes were significantly higher in the poor collateral group (81% vs. 20%, p<0.001). Sensitivity, specificity, and the positive and negative predictive values of fQRS for myocardial scar identification were 89.4%, 87.5%, and 91.3% and 84.8%, respectively. The summed stress score and the summed rest score on SPECT were significantly higher in the poor collateral group than in the well-developed group (p<0.001) as well as in the fQRS group than the non-fQRS group (p<0.001). Logistic regression analysis revealed that the presence of fQRS was significantly and independently associated with poor collateral circulation and myocardial scar in patients with CTO.
conclusionFragmented QRS is independently related to poor coronary collateral circulation in patients with CTO without prior myocardial infarction. Notably, it can be a good predictor of myocardial scar rather than merely ischemia, with high diagnostic accuracy.
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