The presence of J wave or fragmented QRS in the inferior leads predicted a higher risk for sudden cardiac death in patients with dilated (HR 4.095) and ischaemic (HR 2.714) cardiomyopathy.
Cohort (n=1,570)
Does the presence of J wave or fQRS in inferior leads predict sudden cardiac death in patients with chronic heart failure?
The presence of J wave or fragmented QRS in inferior leads on ECG serves as an independent predictor of sudden cardiac death in patients with chronic heart failure.
Effect estimate: HR 4.095 (95% CI 2.132-7.863)
p-value: p=<0.001
AIMS: To investigate the relationship between electrocardiogram (ECG) parameters J wave, fragmented QRS (fQRS), QTc, the peak-to-end interval of T wave (Tp-Te), and sudden cardiac death (SCD) in chronic heart failure (CHF). METHODS AND RESULTS: The ECGs of 1570 CHF patients, 572 cases with dilated cardiomyopathy (DCM) and 998 cases with ischaemic cardiomyopathy (ICM) were analysed with the endpoint being an SCD or non-SCD (NSCD). During a median follow-up period of 36 months (0.40-65 months), 438 (27.89%) patients died, of which 158 (35.84%) were SCD. Overall, the occurrence of J wave, fQRS, and long Tp-Te were greater in SCD patients than that of NSCD patients (all P< 0.01). For DCM cases, more SCD patients had J waves observed in the inferior leads than that in the NSCD group (26.78 vs. 13.07%, P<0.001). However, ICM cases with SCD did have more fQRS in the inferior leads than that with NSCD (42.16 vs. 26.67%, P= 0.01). After adjusting for other risk factors, Cox regression analysis revealed that presence of J wave or fQRS in the inferior leads predicted a higher risk for SCD in DCM hazard ratio (HR), 4.095; 95% confidence interval (CI), 2.132-7.863 and ICM (HR, 2.714; 95% CI, 1.809-4.072) patients. A left ventricular ejection fraction ≤ 30% also predicted SCD and NSCD in DCM and ICM patients. In contrast, the predictive value of QTc and Tp-Te for SCD was not significant. CONCLUSIONS: Presence of J wave or fQRS in the inferior leads predicted higher risk of SCD in DCM and ICM patients and might serve as independent predictors for SCD in patients with CHF.
Pei et al. (Thu,) conducted a cohort in Chronic heart failure (n=1,570). Presence of J wave or fragmented QRS (fQRS) in inferior leads vs. Absence of J wave or fQRS was evaluated on Sudden cardiac death (SCD) (HR 4.095, 95% CI 2.132-7.863, p=<0.001). The presence of J wave or fragmented QRS in the inferior leads predicted a higher risk for sudden cardiac death in patients with dilated (HR 4.095) and ischaemic (HR 2.714) cardiomyopathy.