Key result
The presence of fragmented QRS was associated with a nearly 4-fold increased risk of future arrhythmic events in patients with Brugada syndrome (RR 3.88).
Why the study?
Does the presence of fragmented QRS predict future arrhythmic events in patients with Brugada syndrome?
Meta-Analysis (n=1,637)
Does the presence of fragmented QRS predict future arrhythmic events in patients with Brugada syndrome?
The presence of fragmented QRS on ECG is associated with a nearly 4-fold increased risk of future arrhythmic events in patients with Brugada syndrome, serving as a valuable non-invasive risk stratification tool.
May aid fQRS-based risk stratification in Brugada syndrome; extends observational evidence but requires prospective validation.
Fragmented QRS (fQRS) is an electrocardiographic marker related to ventricular fibrillation (VF) and sudden cardiac death (SCD) in various clinical settings. Current data regarding the prognostic significance of fQRS in Brugada syndrome (BrS) are contradictory. This meta-analysis aimed to evaluate the presence of fQRS as a risk stratification tool in BrS. Electronic databases (PubMed, EMBASE and Cochrane Library) were searched until May 2016. Eight observational studies accumulating data on 1,637 BrS patients (mean age: 47±11 years) were included in this meta-analysis. The mean follow-up duration ranged from 21 to 96 months. fQRS was found to be an independent predictor of future arrhythmic events in BrS (RR:3.88, 95% CI 2.26 to 6.65, p < 0.00001) with moderate heterogeneity (I2 = 54%, P=0.03). When analyzing VF as independent end-point, the RR for VF was 3.61, and its 95% CI was 2.11 to 6.18, p < 0.00001. This meta-analysis showed that BrS patients with fQRS are at high risk for future arrhythmic events. The presence of fQRS warrants prospective evaluation as valid arrhythmogenic risk marker in BrS.
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Meng et al. (2017) conducted a meta-analysis in Brugada syndrome (n=1,637). Fragmented QRS (fQRS) vs. Absence of fragmented QRS was evaluated on Future arrhythmic events (ventricular fibrillation, sudden cardiac death, or appropriate implantable cardioverter-defibrillator therapy) (RR 3.88, 95% CI 2.26 to 6.65, p=<0.00001). The presence of fragmented QRS was associated with a nearly 4-fold increased risk of future arrhythmic events in patients with Brugada syndrome (RR 3.88).
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