Prevalence and Clinical Significance of QRS Fragmentation and Low QRS Voltages in Elite Female Football Players.

In elite female footballers, fQRS is a common ECG finding strongly associated with physiological biventricular remodelling, particularly of the right ventricle. Within the context of this screening programme, fQRS was not associated with detectable cardiac pathology or adverse events, suggesting it may represent a feature of the athlete's heart rather than underlying disease. Conversely, the extreme rarity of low QRS voltage suggests it warrants clinical suspicion if detected. These sex-specific findings provide a new reference for interpreting ECGs in this unique population.