The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease
Open accessAbstract
Background— Q waves on a 12-lead ECG are markers of a prior myocardial infarction (MI). However, they may regress or even disappear over time, and there is no specific ECG sign of a non–Q-wave MI. Fragmented QRS complexes (fQRSs), which include various RSR′ patterns, without a typical bundle-branch block are markers of altered ventricular depolarization owing to a prior myocardial scar. We postulated that the presence of an fQRS might improve the ability to detect a prior MI compared with Q waves alone by ECG. Methods and Results— A cohort of 479 consecutive patients (mean±SD age, 58.2±13.2 years; 283 males) who were referred for nuclear stress tests was studied. The fQRS included various morphologies of the QRS (<120 ms), which included an additional R wave (R′) or notching in the nadir of the S wave, or >1 R′ (fragmentation) in 2 contiguous leads, corresponding to a major coronary artery territory. The Q wave was present in 71 (14.8%) patients, an fQRS was present in 191 (34.9%) patients, and an fQRS and/or a Q wave was present in 203 (42.3%) patients. Sensitivity, specificity, and the negative predictive value for myocardial scar as detected by single photon emission computed tomography analysis were 36.3%, 99.2%, and 70.8%, respectively, for the Q wave alone; 85.6%, 89%, and 92.7%, respectively, for the fQRS; and 91.4%, 89%, and 94.2%, respectively, for the Q wave and/or fQRS. Conclusions— The fQRS on a 12-lead ECG is a marker of a prior MI, defined by regional perfusion abnormalities, which has a substantially higher sensitivity and negative predictive value compared with the Q wave.
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Cited by
Morita, H., Kusano, K. F., Miura, D., Nagase, S., Nakamura, K., Morita, S. T., Ohe, T., Zipes, D. P., & Wu, J. (2008) · Circulation · doi:10.1161/circulationaha.108.770917 · Cited by 470
Fragmented Wide QRS on a 12-Lead ECG: A Sign of Myocardial Scar and Poor Prognosis
Das, M. K., Suradi, H., Maskoun, W., Michael, M. A., Shen, C., Peng, J., Dandamudi, G., & Mahenthiran, J. (2008) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.107.763284 · Cited by 362
Self-citationEHRA/HRS/APHRS expert consensus on ventricular arrhythmias
Pedersen, C. T., Kay, G. N., Kalman, J., Borggrefe, M., Della-Bella, P., Dickfeld, T., Dorian, P., Huikuri, H., Kim, Y.-H., Knight, B., et al. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.07.024 · Cited by 288
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Metadata
- Authors
- Das, M. K., Khan, B., Jacob, S., Kumar, A., & Mahenthiran, J.
- Venue
- Circulation
- Published
- 2006-05-30
- Volume
- 113
- Issue
- 21
- Pages
- 2495-2501
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W1986706069
- Cited by
- 632
- References
- 15
- FWCI
- 6.12
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Das, M. K., Khan, B., Jacob, S., Kumar, A., & Mahenthiran, J. (2006). Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery Disease. Circulation. https://doi.org/10.1161/circulationaha.105.595892
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