Open AccessFragmented QRS on far‐field intracardiac electrograms as a predictor of arrhythmic events
Author(s) -
Osaka Yuki,
Ono Yuichi,
Goto Kentaro,
Yabe Kento,
Tanaka Akifumi,
Miyazaki Toru,
Suzuki Asami,
Kurihara Ken,
Goya Masahiko,
Otomo Kenichiro,
Sasano Tetsuo
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12622
Subject(s) - medicine , ventricular tachycardia , cardiology , implantable cardioverter defibrillator , logistic regression , sudden cardiac death , qrs complex
Background Studies suggest that fragmented QRS (fQRS) can predict arrhythmic events in various cardiac diseases. However, the association between fQRS recordings on intracardiac electrogram (EGM) and ventricular arrhythmic events remains unknown. Methods We enrolled 51 patients (age, 62 ± 12 years; 40 men) with an implantable cardioverter‐defibrillator (ICD) and structural heart disease and evaluated surface electrocardiogram (ECG) and EGM measurement of fQRS and the association between fQRS and arrhythmic events. Results fQRS was detected on surface ECG and ICD‐EGM in 12 (23.5%) and 15 (29.4%) patients, respectively. fQRS was detected more frequently on ICD‐EGM in patients with fQRS on surface ECG than in patients without fQRS (7/12 [58.3%] vs 8/39 patients [20.5%], P = .01). Appropriate ICD therapies were documented in 16 patients. Among these patients, fQRS was detected more frequently on surface ECG and ICD‐EGM in patients with appropriate ICD therapies (8/16, 50.0%; P = .001 and 11/16, 68.9%; P < .001). Nonsustained ventricular tachycardia was significantly more frequent in patients with appropriate ICD therapies (15/16, 93.8%; P = .04). Multiple logistic regression analysis showed that fQRS on ICD‐EGM was a predictor of arrhythmic events ( P = .03). Kaplan‐Meier survival analysis revealed that ICD therapies were significantly more frequent among patients with fQRS on both surface ECG and ICD‐EGM than among those without fQRS (66.7% vs 6.6%, P < .001). Conclusion The presence of fQRS on ICD‐EGM can be a predictor of arrhythmic events in ICD patients. Surface ECG and ICD‐EGM measurement may help predict ventricular arrhythmic events.