Abstract:Fragmented QRS complex(fQRS) is regarded to derive from conduction delay caused by myocardial scar, which is commonly seen in patients with coronary heart disease and myocardial infarction, and also in patients suffering from cardiomyopathy and congenital heart disease. Clinically, fQRS plays important roles in the prediction, prevention and treatment of arrhythmogenic right ventricular cardiomyopathy, and the early warning of Brugada syndrome and nonischemic cardiomyopathy. Since the risk stratification of sudden cardiac death(SCD) is obviously bounded in major risk factors and predictors, it is required to explore new noninvasive electrocardiologic examination method. fQRS can be considered as one of the important parts in the risk stratification or risk score of SCD.
刘刚, 马芳芳. 碎裂QRS波和心脏性猝死相关性的研究进展[J]. 实用心电学杂志, 2016, 25(4): 240-243.
LIU Gang, MA Fang-Fang. Research progress on the relativity between fragmented QRS complex and sudden cardiac death. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2016, 25(4): 240-243.
[1] Das MK, Khan B, Jacob S, et al. Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease[J]. Circulation, 2006, 113(21):2495-2501.[2] Das MK, Saha C, El Masry H, et al. Fragmented QRS on a 12lead ECG: a predictor of mortality and cardiac events in patients with coronary artery disease[J]. Heart Rhythm, 2007, 4(11):[JP]1385-1392.[3] Das MK, Zipes DP. Fragmented QRS: a predictor of mortality and sudden cardiac death[J]. Heart Rhythm, 2009, 6 (3 Suppl):S8-S14.[4] Kang KW, Janardhan AH, Jung KT, et al.Fragmented QRS as a candidate marker for highrisk assessment in hypertrophic cardiomyopathy[J].Heart Rhythm, 2014, 11(8):1433-1440.[5] Debonnaire P, Katsanos S, Joyce E, et al. QRS fragmentation and QTc duration relate to malignant ventricular tachyarrhythmias and sudden cardiac death in patients with hypertrophic cardiomyopathy[J]. J Cardiovasc Electrophysiol, 2015, 26(5):547-555. [6] Nomura A, Konno T, Fujita T, et al. Fragmented QRS predicts heart failure progression in patients with hypertrophic cardiomyopathy[J]. Circ J, 2015, 79(1):136-143.[7] Femenía F, Arce M, Van Grieken J, et al. Fragmented QRS as a predictor of arrhythmic events in patients with hypertrophic obstructive cardiomyopathy[J]. J Interv Card Electrophysiol, 2013, 38(3):159-165. [8] Das MK, Zipes DP. Antiarrhythmic and nonantiarrhythmic drugs for sudden cardiac death prevention[J]. J Cardiovasc Pharmacol, 2010, 55(5):438-449.[9] etin M, Kocaman SA, Erdoan T, et al. The independent relationship of systemic inflammation with fragmented QRS complexes in patients with acute coronary syndromes[J]. Korean Circ J, 2012, 42(7):449-457.[10] Das MK, Michael MA, Suradi H, et al. Usefulness of fragmented QRS on a 12-lead electrocardiogram in acute coronary syndrome for predicting mortality[J]. Am J Cardiol, 2009, 104(12):1631-1637.[11] Akbarzadeh F, Pourafkari L, Ghaffari S, et al. Predictive value of the fragmented QRS complex in 6month mortality and morbidity following acute coronary syndrome[J]. Int J Gen Med, 2013(6):399-404.[12] Das MK, Maskoun W, Shen C, et al. Fragmented QRS on twelvelead electrocardiogram predicts arrhythmic events in patients with ischemic and nonischemic cardiomyopathy[J]. Heart Rhythm, 2010, 7(1):74-80.[13] Brenyo A, Pietrasik G, Barsheshet A, et al. QRS fragmentation and the risk of sudden cardiac death in MADIT Ⅱ[J]. J Cardiovasc Electrophysiol, 2012, 23(12):1343-1348. [14] Pietrasik GM, Polonsky S, Moss AJ, et al. Presence of fragmented wideQRS complex and the risk of death and sudden cardiac death among MADITⅡ patients with left bundle branch block[J]. J Am Coll Cardiol, 2010, 55(10):A13.[15] Rosengarten JA, Scott PA, Morgan JM. Fragmented QRS for the prediction of sudden cardiac death: a metaanalysis[J]. Europace, 2015, 17(6):969-977.[16] Pei J, Li N, Gao Y, et al. The J wave and fragmented QRS complexes in inferior leads associated with sudden cardiac death in patients with chronic heart failure[J]. Europace, 2012, 14(8):1180-1187. [17] Morita H, Kusano KF, Miura D et al. Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome[J]. Circulation, 2008, 118(17): 1697-1704.[18] Peters S, Trümmel M, Koehler B. QRS fragmentation in standard ECG as a diagnostic marker of arrhythmogenic right ventricular dysplasiacardiomyopathy[J]. Heart Rhythm, 2008, 5(10): 1417-1421.[19] Narayanan K, Zhang L, Kim C, et al. QRS fragmentation and sudden cardiac death in the obese and overweight[J]. J Am Heart Assoc, 2015, 4(3):e001654.[20] Gotsman I, Keren A, Hellman Y, et al. Usefulness of electrocardiographic frontal QRS-T angle to predict increased morbidity and mortality in patients with chronic heart failure[J]. Am J Cardiol, 2013, 111(10):1452-1459.[21] Yamazaki T, Froelicher VF, Myers J, et al. Spatial QRS-T angle predicts cardiac death in a clinical population[J]. Heart Rhythm, 2005, 2(1):73-78.[22] Chatterjee S, Changawala N. Fragmented QRS complex: a novel marker of cardiovascular disease[J]. Clin Cardiol, 2010, 33(2):68-71.