Fragmented QRS and Ventricular Arrhythmias in Coroary Artery Disease Patients

Background: Fragmented QRS represents myocardial scar and will be associated with ventricular dysfunction and occurrence of congestive heart failure. In CAD, fQRS represents prior occurrence of myocardial infarction and will have a risk of subsequent occurrence of ischemic events. Objective: in our study we aimed to determine whether fragmented QRS (fQRS) is associated with increased incidence of ventricular arrhythmias in patients with coronary artery disease (CAD) or not . Patients and Methods: one hundred patients with CAD were included. Patients were divided into two groups according to presence or absence of fQRS on admission ECG. Group 1 (n=50) was defined as a fQRS (+ve) and group 2 (n=50) was defined as a fQRS (-ve). All patients were subjected to full history taking, complete physical examination, ECG, echocardiography and laboratory investigations. Results: There was higher incidence of fQRS in hypertensive patients (72%). FQRS was found to be associated with increased incidence of ventricular arrhythmias, 52% in group 1 versus 24% in group II. EF % was significantly lower in group I than in group 2 with p value 0.03. Fragmented QRS was an independent predictor of all-cause mortality with p value 0.02. Conclusion: fQRS on the resting surface electrocardiogram is a simple, fast and inexpensive modality of noninvasive investigation for evaluation of CAD patients. Patients who have known CAD present with a fQRS have an increased rate of ventricular tachyarrhythmias, death risk, and low ejection fraction.