Fragmented QRS and other depolarization abnormalities as a predictor of mortality and sudden cardiac death

Mithilesh Das, Hicham El Masry

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Purpose of Review: Several invasive and noninvasive tests for risk stratification of sudden cardiac death (SCD) have been studied. Tests such as microwave T wave alternans (repolarization abnormality) and signal-averaged ECG (depolarization abnormality) have high negative predictive values but low positive predictive values in patients with heart disease. The presence of a fragmented QRS (fQRS) complex on a routine 12-lead ECG is another marker of depolarization abnormality. The purpose of this review is to discuss the potential utility of tests to detect depolarization abnormalities of the heart for the risk stratification of mortality and SCD with main emphasis on fQRS. Recent Findings: fQRS is associated with increased mortality and arrhythmic events in patients with coronary artery disease. fQRS has also been defined as a marker of arrhythmogenic right ventricular cardiomyopathy and Brugada syndrome. In Brugada syndrome, the presence of fQRS predicts episodes of ventricular fibrillation during follow-up. fQRS may be of value in determining the risk for SCD and guiding selection for device therapy in patients with structural heart disease and Brugada syndrome. It is possible that the predictive value of fQRS for SCD can be enhanced further by combining a marker of repolarization abnormality such as microwave T wave alternans.

Original languageEnglish
Pages (from-to)59-64
Number of pages6
JournalCurrent Opinion in Cardiology
Volume25
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Sudden Cardiac Death
Brugada Syndrome
Mortality
Microwaves
Heart Diseases
Electrocardiography
Arrhythmogenic Right Ventricular Dysplasia
Congenital Heart Defects
Ventricular Fibrillation
Coronary Artery Disease
Equipment and Supplies
Therapeutics

Keywords

  • Arrhythmic events
  • Fragmented QRS
  • Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Fragmented QRS and other depolarization abnormalities as a predictor of mortality and sudden cardiac death. / Das, Mithilesh; El Masry, Hicham.

In: Current Opinion in Cardiology, Vol. 25, No. 1, 01.2010, p. 59-64.

Research output: Contribution to journalArticle

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