What is the clinical evidence from this study?

Study design: Review. Population: Sudden cardiac death risk stratification. Intervention: Fragmented QRS (fQRS). Primary outcome: Mortality and sudden cardiac death.

What does this research mean for the field?

Fragmented QRS on a routine 12-lead ECG is associated with increased mortality and arrhythmic events in coronary artery disease and predicts ventricular fibrillation in Brugada syndrome, making it a valuable marker for sudden cardiac death risk stratification. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

December 5, 2009

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

Key Result

Fragmented QRS on a routine 12-lead ECG is associated with increased mortality and arrhythmic events in coronary artery disease and predicts ventricular fibrillation in Brugada syndrome.

Structured PICO

Does the presence of fragmented QRS on a 12-lead ECG predict mortality and sudden cardiac death in patients with structural heart disease and Brugada syndrome?

Population

Patients with structural heart disease, coronary artery disease, arrhythmogenic right ventricular cardiomyopathy, and Brugada syndrome

Intervention

Fragmented QRS (fQRS) on routine 12-lead ECG

Outcome

Mortality and sudden cardiac death (SCD)hard clinical

Fragmented QRS on a routine 12-lead ECG may be a valuable noninvasive marker for risk stratification of sudden cardiac death and guiding device therapy selection in patients with structural heart disease and Brugada syndrome.

Abstract

PURPOSE OF REVIEW: Several invasive and noninvasive tests for risk stratification of sudden cardiac death (SCD) have been studied. Tests such as microwave T wave alternans (repolarization abnormality) and signal-averaged ECG (depolarization abnormality) have high negative predictive values but low positive predictive values in patients with heart disease. The presence of a fragmented QRS (fQRS) complex on a routine 12-lead ECG is another marker of depolarization abnormality. The purpose of this review is to discuss the potential utility of tests to detect depolarization abnormalities of the heart for the risk stratification of mortality and SCD with main emphasis on fQRS. RECENT FINDINGS: fQRS is associated with increased mortality and arrhythmic events in patients with coronary artery disease. fQRS has also been defined as a marker of arrhythmogenic right ventricular cardiomyopathy and Brugada syndrome. In Brugada syndrome, the presence of fQRS predicts episodes of ventricular fibrillation during follow-up. SUMMARY: fQRS may be of value in determining the risk for SCD and guiding selection for device therapy in patients with structural heart disease and Brugada syndrome. It is possible that the predictive value of fQRS for SCD can be enhanced further by combining a marker of repolarization abnormality such as microwave T wave alternans.

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Cite This Study

Das et al. (Sat,) conducted a review in Sudden cardiac death risk stratification. Fragmented QRS (fQRS) was evaluated on Mortality and sudden cardiac death. Fragmented QRS on a routine 12-lead ECG is associated with increased mortality and arrhythmic events in coronary artery disease and predicts ventricular fibrillation in Brugada syndrome.

synapsesocial.com/papers/6a193e75b1a1e919c388c6cc https://doi.org/https://doi.org/10.1097/hco.0b013e328333d35d

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