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Arch Cardiol Mex. 2018 Apr - Jun;88(2):124-128. doi: 10.1016/j.acmx.2016.12.008. Epub 2017 Jan 24.

QRS-fragmentation: Case report and review of the literature.

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National Institute of Cardiology Ignacio Chávez, Mexico. Electronic address:
National Institute of Cardiology Ignacio Chávez, Mexico.
Nuclear Cardiology Department, National Institute of Cardiology Ignacio Chávez, Mexico.
Coronary Care Unit, National Institute of Cardiology Ignacio Chávez, Mexico.


Fragmentation of QRS complex (QRSf) is an easily evaluable, non-invasive electrocardiographic parameter that represents depolarisation anomalies and has been associated with several adverse outcomes, such as sudden death, fibrosis, arrhythmic burden, and a worse prognosis in different conditions, including coronary artery disease (CAD). The case is presented of a 69-year old male referred due to symptoms of chronic stable angina. His electrocardiogram showed sinus rhythm, absence of Q waves, but the presence of QRSf in the inferior leads and V4-V6. A Tc-99 myocardial perfusion SPECT scan revealed a fixed perfusion defect in the inferolateral region, corresponding to the finding of QRSf. QRSf is an easily valuable electrocardiographic marker with relative sensitivity, but poor specificity. Its routine clinical application could contribute to an increase in the suspicion of coronary artery disease.


The presence of fragmented QRS represents distortion of signal conduction and depolarisation, which is related to myocardial scar or myocardial fibrosis.


Cardiomiopatía; Cardiomyopathy; Coronary artery disease; Enfermedad arterial coronaria; Fragmentación del QRS; Fragmentation of QRS; Muerte súbita; México; Prognosis; Pronóstico; Sudden death

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