Fragmented QRS was an independent predictor of cardiovascular death in patients with structural heart disease and inducible VT/VF (HR 4.58; 95% CI 1.34-15.64; P=0.015).
Cohort (n=98)
Does the presence of fragmented QRS predict all-cause mortality and cardiovascular death in patients with structural heart disease and inducible VT/VF?
The presence of fragmented QRS on a 12-lead ECG is an independent predictor of cardiovascular death in patients with structural heart disease and inducible VT/VF who receive an ICD.
Effect estimate: HR 4.58 (95% CI 1.34-15.64)
Absolute Event Rate: 30% vs 6%
p-value: p=0.015
BACKGROUND: Fragmented QRS (fQRS) can predict cardiac events, and inducible ventricular tachycardia/fibrillation (VT/VF) is a known high-risk factor for arrhythmic death. However, whether fQRS is a predictor of cardiac events in patients with inducible VT/VF is unknown. We aimed to evaluate whether fQRS is a predictor of cardiac events in patients with structural heart disease and inducible VT/VF. METHODS AND RESULTS: We retrospectively investigated 98 patients with structural heart disease who had a defibrillator device implanted. All patients underwent electrophysiological testing prior to or after device implantation and VT/VF was induced. fQRS was present in 30 patients. Appropriate defibrillator therapies were similar between the fQRS and non-fQRS groups (47% vs. 47%). In total, 25 patients (26%) died during a mean follow-up period of 87±43 months. All-cause mortality (12 40% vs. 13 19%) and cardiovascular deaths (9 30% vs. 4 6%) were significantly higher in the fQRS group than non-fQRS group, respectively; Kaplan-Meier analysis revealed significantly lower event-free survival for all-cause mortality (P=0.012) and cardiovascular deaths (P=0.001) for fQRS patients. A multivariable Cox regression model revealed that fQRS was an independent predictor of cardiovascular death (hazard ratio, 4.58; 95% confidence interval, 1.34-15.64; P=0.015). CONCLUSIONS: fQRS is a predictor of cardiovascular death in patients with structural heart disease and inducible VT/VF.
Hayashi et al. (Tue,) conducted a cohort in Structural heart disease with inducible VT/VF (n=98). Fragmented QRS (fQRS) vs. Non-fQRS was evaluated on Cardiovascular death (HR 4.58, 95% CI 1.34-15.64, p=0.015). Fragmented QRS was an independent predictor of cardiovascular death in patients with structural heart disease and inducible VT/VF (HR 4.58; 95% CI 1.34-15.64; P=0.015).