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Clinical significance of fragmented QRS complexes or J waves in patients with idiopathic ventricular arrhythmias.

ABSTRACT: Idiopathic ventricular fibrillation (IVF) can cause sudden cardiac death. Previous studies have reported that J waves and fragmented QRS complexes (f-QRS) are arrhythmogenic markers and predictors of cardiac events. We evaluated the prevalence and clinical significance of J waves and f-QRS in patients with IVF.We studied 81 patients who received an implantable cardioverter defibrillator (ICD) due to IVF between October 1999 and June 2015. We assessed the prevalence of J waves and f-QRS using electrocardiograms (ECGs). Patients were classified into three groups: J wave group (n = 35), f-QRS group (n = 20), or normal ECG group (n = 26). The control group included 81 subjects without heart disease who were matched for age, sex, and race. We compared syncope, sudden cardiac arrest, and appropriate ICD shock between the three groups.The follow-up duration was 4.1 years. J waves and f-QRS were more frequent in patients with IVF than in control subjects (43.2%, 21% vs. 24.7%, 19.7%, P < 0.001). Out of the three groups, clinical cardiac events were most frequent in the f-QRS group (50% vs. 45.7% vs. 11.5%, P = 0.028). A comparison of the combined group of J wave and f-QRS versus the normal ECG group revealed that the combined group had a higher frequency of clinical cardiac events than the normal ECG group (47.3% vs. 11.5%, respectively, P = 0.009).Patients with IVF had higher prevalence of f-QRS or J waves. And patients with f-QRS or J waves were at higher risk of recurrent ventricular fibrillation.

SUBMITTER: Seong CS

PROVIDER: S-EPMC5919047 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Clinical significance of fragmented QRS complexes or J waves in patients with idiopathic ventricular arrhythmias.

Seong Choong Sil CS Gwag Hye Bin HB Hwang Jin Kyung JK Park Seung Jung SJ Park Kyoung-Min KM Kim June Soo JS On Young Keun YK

PloS one 20180425 4

<h4>Background</h4>Idiopathic ventricular fibrillation (IVF) can cause sudden cardiac death. Previous studies have reported that J waves and fragmented QRS complexes (f-QRS) are arrhythmogenic markers and predictors of cardiac events. We evaluated the prevalence and clinical significance of J waves and f-QRS in patients with IVF.<h4>Methods</h4>We studied 81 patients who received an implantable cardioverter defibrillator (ICD) due to IVF between October 1999 and June 2015. We assessed the preval ...[more]

PMID: 29694354

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Project description:BackgroundFragmented QRS (f-QRS) complex on the surface ECG is a cardiac conduction abnormality that indicates myocardial scarring. The relationship between the f-QRS complex and cardiac status in patients with Danon disease (DD) remains unclear and will be explored in this study.MethodsPatients with genetically confirmed DD and cardiac magnetic resonance imaging (CMR) examinations were recruited from multiple centers. The number of leads, pattern, score, and segmental distribution of the f-QRS complex were assessed by surface 12-lead ECG. Cardiac status, such as left ventricular (LV) volume, function, and extent of late gadolinium enhancement (LGE), was demonstrated by CMR. The segmental distribution of LGE was also assessed. Correlations between the f-QRS and cardiac status were assessed.ResultsFifteen patients (14 men) with DD who underwent 12-lead ECG and CMR imaging were included. The f-QRS complex was documented in all patients (n = 15, 100%). Three patterns of f-QRS were found, with the notched R/S pattern (74%) being the most common, followed by fragmented QRS (16%) and various RSR' (11%). The fragmented QRS pattern showed an association with a higher level of myocardial fibrosis (LGE > 35%). The burden of f-QRS in each patient was assessed by the number of leads with f-QRS (median 7, range 2-12) and the f-QRS score (median 9, range 2-33). In the correlation analysis, the f-QRS score was positively correlated with LGE% (r = 0.726, p = 0.002), negatively correlated with LV ejection function (LVEF; r = -0.617, p = 0.014) as evaluated by CMR. In the local distribution, f-QRS score and LGE% were both predominant in the LV free wall but did not correlate well among the anterior, lateral, and inferior segments.ConclusionIn this DD cohort, the quantitative f-QRS was correlated well with myocardial fibrosis burden and LV dysfunction in general. This finding suggests that f-QRS can be used as a simple screening tool to assess cardiac status in patients with DD.

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Clinical significance of fragmented QRS complexes or J waves in patients with idiopathic ventricular arrhythmias.

Publications

Clinical significance of fragmented QRS complexes or J waves in patients with idiopathic ventricular arrhythmias.

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