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Ann Noninvasive Electrocardiol. 2011 Jul;16(3):270-5. doi: 10.1111/j.1542-474X.2011.00442.x.

Fragmented QRS is associated with all-cause mortality and ventricular arrhythmias in patient with idiopathic dilated cardiomyopathy.

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1
Center for Arrhythmia Diagnosis and Treatment, Fu Wai Cardiovascular Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

BACKGROUND:

Several studies have showed that fragmented QRS complexes (f - QRS, defined as different RSR' patterns) on a routine 12 - lead electrocardiogram were associated with increased mortality and arrhythmic events in patients with coronary artery disease, but relatively little data were available regarding idiopathic dilated cardiomyopathy (IDCM).

OBJECTIVE:

The purpose of this study was to evaluate the relationship between fragmentation of QRS and the combined end point of all-cause mortality and ventricular arrhythmias in patients with IDCM.

METHODS:

One hundred twenty-eight patients with IDCM and left ventricular dysfunction (ejection fraction, EF ≤ 40%) were analyzed, respectively. According to QRS duration and the existence of f - QRS on 12-lead electrocardiograph (ECG), the study populations were divided into three groups: (1) the f - QRS group (QRS <120 ms and with fragmented QRS, n = 51), (2) the wide QRS (wQRS) group (QRS ≥ 120 ms, n = 48), and (3) the nonfragmented QRS (non-fQRS) group (QRS < 120 ms and without f - QRS, n = 29).

RESULTS:

During a mean follow-up of 14 ± 5 months, 25 (19.5%) patients had deaths and ventricular arrhythmic events. The combined end point of all-cause mortality and ventricular tachyarrhythmias was significantly higher in the f - QRS and wQRS groups than the non-fQRS group (23.5%, 25%, and 3.4%, respectively; P < 0.05 for both). Event-free was significantly decreased in the f - QRS group versus the non-fQRS group (P = 0.02). Univaritae regression analysis revealed that f - QRS was a stronger predictor of mortality and arrhythmic events in IDCM patients.

CONCLUSION:

f - QRS on 12-lead ECG has a high predictive value for the combined end point of all-cause mortality and ventricular tachyarrhythmias in IDCM patients with left ventricular dysfunction.

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