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Fragmented QRS Complex Predicts the Arrhythmic Events in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
Author(s) -
CANPOLAT UĞUR,
KABAKÇI GIRAY,
AYTEMIR KUDRET,
DURAL MUHAMMET,
ŞAHINER LEVENT,
YORGUN HIKMET,
SUNMAN HAMZA,
BARIŞ KAYA ERGÜN,
TOKGÖZOĞLU LALE,
OTO ALI
Publication year - 2013
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12202
Subject(s) - medicine , cardiology , qrs complex , arrhythmogenic right ventricular dysplasia , left bundle branch block , ventricular fibrillation , bundle branch block , cardiomyopathy , atrial fibrillation , electrocardiography , heart failure
frQRS and Outcomes in ARVC/D Background Fragmented QRS (frQRS) complex, with various morphology, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, there are little data regarding the prognostic role of frQRS in these patients. Therefore, we aimed to investigate the association of frQRS with arrhythmic events in patients with ARVC/D. Methods Seventy‐eight patients (51 men, 65.4%; mean age: 31.25 ± 11.5 years) with the diagnosis of ARVC/D according to 2010 modified Task Force Criteria were analyzed retrospectively. Baseline ECG evaluation revealed frQRS complex in 46 patients (59%). Eleven patients with complete/incomplete right bundle branch block were excluded from the study. The phenomenon of frQRS was defined as deflections at the beginning of the QRS complex, on top of the R‐wave, or in the nadir of the S‐wave similar to the definition in CAD in either one right precordial lead or in more than one lead including all standard ECG leads. Results During 38 ± 14 months follow‐up period, 3 patients (3.8%) died suddenly, 36 patients (46.1%) experienced arrhythmic events (32 ventricular tachycardias [VTs] and 4 ventricular fibrillation [VF], 30 in the ICD group). The frQRS was significantly associated with arrhythmic events (P < 0.001). Also, the number of ECG leads with frQRS complex was higher in patients with arrhythmic events (5.08 ± 2.5 vs 1.14 ± 1.7, P < 0.001, respectively). Conclusion The frQRS complex on standard 12‐lead ECG predicts fatal and nonfatal arrhythmic events in patients with ARVC/D. Therefore, large scale and prospective studies are needed to confirm those findings.