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QRS Fragment

Chanavuth Kanitsoraphan, Pattara Rattanawong, Poemlarp Mekraksakit, Pakawat Chongsathidkiet, Tanawan Riangwiwat, Napatt Kanjanahattakij, Wasawat Vutthikraivit, Saranapoom Klomjit, Subhanudh Thavaraputta
BACKGROUND: Recent studies suggested that fragmented (fQRS) is associated with poor clinical outcomes in heart failure with reduced ejection fraction (HFrEF) patients. However, no systematic review or meta-analysis has been done. We conducted a systematic review and meta-analysis to assess the association between baseline fQRS and all-cause mortality in HFrEF. METHODS: We comprehensively reviewed the databases of MEDLINE and EMBASE from inception to February 2018...
October 17, 2018: Annals of Noninvasive Electrocardiology
Bert Vandenberk, M Juhani Junttila, Tomas Robyns, Christophe Garweg, Joris Ector, Heikki V Huikuri, Rik Willems
BACKGROUND: Sudden cardiac death (SCD) results from a complex interplay of abnormalities in autonomic function, myocardial substrate and vulnerability. We studied whether a combination of noninvasive risk stratification tests reflecting these key players could improve risk stratification. METHODS: Patients implanted with an ICD in whom 24-hr holter recordings were available prior to implant were included. QRS fragmentation (fQRS) was selected as measure of myocardial substrate and a high ventricular premature beat count (VPB >10/hr) for arrhythmic vulnerability...
September 28, 2018: Annals of Noninvasive Electrocardiology
Jack T Reynard, Oluwayemisi M Oshodi, Jenny Lai, Rachel Lai, George Bazoukis, Nikolaos Fragakis, Konstantinos P Letsas, Panagiotis Korantzopoulos, Fang-Zhou Liu, Tong Liu, Yunlong Xia, Gary Tse, Ka H Li
The QT interval along with its heart rate corrected form (QTc) are well- established ECG markers that have been found to be associated with malignant ventricular arrhythmogenesis. However, extensive pre-clinical and clinical investigations over the years have allowed for novel clinical ECG markers to be generated as predictors of arrhythmogenesis and sudden cardiac death. Repolarization markers include the older QTc, QT dispersion and newer Tpeak - Tend intervals, (Tpeak - Tend) / QT ratios, T-wave alternans (TWA), microvolt TWA and T-wave area dispersion...
September 26, 2018: Minerva Cardioangiologica
Özal Yıldırım, Paweł Pławiak, Ru-San Tan, U Rajendra Acharya
This article presents a new deep learning approach for cardiac arrhythmia (17 classes) detection based on long-duration electrocardiography (ECG) signal analysis. Cardiovascular disease prevention is one of the most important tasks of any health care system as about 50 million people are at risk of heart disease in the world. Although automatic analysis of ECG signal is very popular, current methods are not satisfactory. The goal of our research was to design a new method based on deep learning to efficiently and quickly classify cardiac arrhythmias...
September 15, 2018: Computers in Biology and Medicine
Pauline Berthome, Romain Tixier, Jean Briand, Olivier Geoffroy, Dominique Babuty, Jacques Mansourati, Laurence Jesel, Jean-Marc Dupuis, Paul Bru, Florence Kyndt, Béatrice Guyomarch, Aurélie Thollet, Nathalie Behar, Philippe Mabo, Frédéric Sacher, Vincent Probst, Jean-Baptiste Gourraud
BACKGROUND: Studies in Brugada syndrome (BrS) have mainly consisted of men. OBJECTIVE: The purpose of this study was to describe the clinical characteristics and arrhythmic risk factors in BrS women. METHODS: Consecutive BrS patients were enrolled from 1993 and followed prospectively. RESULTS: Among 1613 patients, 494 were women (mean age 47 ± 16 years). Women were more frequently asymptomatic than men (423 [86%] vs 867 [77%], respectively; P = ...
September 5, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Anna Kucharz, Piotr Kułakowski
BACKGROUND: Incidence of fragmented (fQRS) and predisposing factors in patients with implantable cardioverter-defibrillator (ICD) have not yet been established. Aim To examine incidence of fQRS, associated factors as well as predictive value in identifying site of coronary artery disease (CAD). METHODS: Consecutive patients with ICD. Retrospective analysis of demographic, clinical and ECG data. RESULTS: Of 382 patients, 163 (43%) had fQRS...
September 2018: Journal of Electrocardiology
Mehmet Eyuboglu, Akar Yilmaz, Onur Dalgic, Caner Topaloglu, Yavuz Karabag, Bahri Akdeniz
BACKGROUND: Fragmented QRS (fQRS) as a sign of myocardial fibrosis indicates adverse outcomes in various cardiovascular diseases. However, there are no clear data regarding relationship between obesity and fQRS. We aimed to investigate whether high body mass index (BMI) predicts fQRS on electrocardiography (ECG) independent of underlying cardiovascular status. METHODS: A total of 1530 patients were included into the study. Patients were divided into three groups according to BMI (normal, overweight and obese)...
September 2018: Journal of Electrocardiology
Mahmut Yesin, Metin Çağdaş, Macit Kalçık, İbrahim Rencüzoğulları, Yavuz Karabağ, Mustafa Ozan Gürsoy, Süleyman Karakoyun
BACKGROUND: Even though the relationship between syntax score (SS) and fragmented QRS (fQRS) has been studied, the relation between syntax score II (SS II) and fQRS in patients with ST elevation myocardial infarction (STEMI) is undefined. We aimed to define the relationship between fQRS and SS II for the evaluation of extension and complexity of coronary artery disease. MATERIAL AND METHODS: This study enrolled 167 patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI...
September 2018: Journal of Electrocardiology
Tanawat Attachaipanich, Rungroj Krittayaphong
BACKGROUND: Fragmented QRS (fQRS) complex is an electrocardiographic pattern that reflects the inhomogeneity of ventricular depolarization. The aims of this study were to determine the prognostic significance of fQRS for predicting in-hospital life-threatening arrhythmic complications in ST-elevation myocardial infarction (STEMI) patients, and to identify the most appropriate duration of cardiac rhythm monitoring in STEMI patients with fQRS. METHODS: Patients diagnosed with and treated for STEMI at Siriraj Hospital (Bangkok, Thailand) during 2009-2012 were enrolled...
August 17, 2018: Annals of Noninvasive Electrocardiology
Orçun Çiftci, Suzan Keskin, Emir Karaçağlar, Kerem Can Yılmaz, Ayşe Aktaş, Siren Sezer, Gökhan Moray, İbrahim Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Coronary artery disease is a major cause of mortality and morbidity after renal transplant. Fragmented QRS on standard 12-lead electrocardiograms has been proposed as a marker of myocardial scar, mainly due to coronary artery disease. Here, we aimed to investigate fragmented QRS to detect severe coronary artery disease in renal transplant candidates. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 534 patients with end-stage renal failure who were on the deceased-donor renal transplant wait list at Başkent University Faculty of Medicine due to having no living kidney donor available...
July 31, 2018: Experimental and Clinical Transplantation
Guo-Liang Li, Ardan M Saguner, Guy H Fontaine, Robert Frank
BACKGROUND: Bradycardia-induced torsade de pointes (TdP) tachycardia in patients with spontaneous high-degree atrioventricular block (AVB) is common. The aim of this study was to analyze endocardial recordings during TdP in spontaneous high-degree AVB in humans to better understand the electrophysiological mechanisms underlying this phenomenon. METHODS: The study group consisted of 5 patients with typical episodes of TdP during spontaneous high-degree AVB. A standard (USCI) temporary bipolar endocardial catheter positioned at the apex of the right ventricle (RV) and bipolar chest leads from two precordial leads V1 and V4 were used to record the tracings during TdP...
July 16, 2018: Cardiology Journal
Derek S Chew, Stephen B Wilton, Katherine Kavanagh, Haris M Vaid, Danielle A Southern, Linda Ellis, Andrew G Howarth, James A White, Derek V Exner
BACKGROUND: Recovery of left ventricular ejection fraction (LVEF) after acute myocardial infarction (MI) is not universal and is difficult to predict. Fragmented QRS (fQRS) complexes are thought to be markers of myocardial scar. We hypothesized that fQRS complexes on 12‑lead surface ECGs during the initial post-MI period would be associated with adverse LV remodeling over the following year. METHODS: Change in LVEF between the early (0-2 month) and later (2-12 month) post-MI periods was assessed in two independent cohorts of post-MI patients with initial LV dysfunction...
July 2018: Journal of Electrocardiology
Wei Xia, Xiao-Yan Feng
BACKGROUND ST-segment elevation myocardial infarction (STEMI) is an acute and life-threatening disease. Adverse cardiac events (ACEs) are defined as cardiovascular death or worsening congestive heart failure in STEMI patients. The present study investigated the predictive role of fragmented QRS complex (fQRS) in risks of ACEs in STEMI. MATERIAL AND METHODS This study was a retrospective analysis involving patients who underwent percutaneous coronary intervention (PCI) or thrombolysis. STEMI patients were divided into the fQRS group (259 cases) and the non-fQRS group (161 cases)...
July 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Hiroshi Morita, Masakazu Miyamoto, Atsuyuki Watanabe, Saori Tsukuda, Yoshimasa Morimoto, Satoshi Kawada, Koji Nakagawa, Nobuhiro Nishii, Hiroshi Ito
BACKGROUND: Various risk stratifications in asymptomatic patients with Brugada syndrome (BrS) have been proposed, but the electrophysiological change that promotes ventricular fibrillation (VF) is still unknown. OBJECTIVE: The aim of this study was to clarify the changes in electrocardiographic (ECG) markers at the onset of VF from ECGs recorded when patients were still asymptomatic. METHODS: The subjects of this study included 14 patients with VF and 48 consecutive asymptomatic patients with BrS...
October 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Can Hasdemir, Jimmy Jyh-Ming Juang, Sedat Kose, Umut Kocabas, Mehmet N Orman, Serdar Payzin, Hatice Sahin, Candan Celen, Emin E Ozcan, Ching-Yu Julius Chen, Ramazan Gunduz, Oguzhan E Turan, Oktay Senol, Elena Burashnikov, Charles Antzelevitch
BACKGROUND: Atrial arrhythmias, particularly atrioventricular nodal reentrant tachycardia, can coexist with drug-induced type 1 Brugada electrocardiogram (ECG) pattern (DI-Type1-BrP). The present study was designed to determine the prevalence of DI-Type1-BrP in patients with atrioventricular accessory pathways (AV-APs) and to investigate the clinical, electrocardiographic, electrophysiologic, and genetic characteristics of these patients. METHODS: One-hundred twenty-four consecutive cases of AV-APs and 84 controls underwent an ajmaline challenge test to unmask DI-Type1-BrP...
September 2018: Pacing and Clinical Electrophysiology: PACE
Fani Zagkli, Stefanos Despotopoulos, Christos Spiliotopoulos, John Chiladakis
Background: The study was designed to investigate the effect of heart rate and pacing mode on QRS fragmentation (f-QRS). Moreover, the usefulness of f-QRS in distinguishing patients with impaired left ventricular ejection function (EF) and ventricular tachycardia (VT) from patients with normal EF was assessed. Methods: Three hundred and six recipients, with dual-chamber device, with intrinsic narrow or wide QRS complex and preserved atrioventricular conduction were grouped into normal-EF or impaired-EF VT...
June 2018: Journal of Arrhythmia
Napatt Kanjanahattakij, Pattara Rattanawong, Tanawan Riangwiwat, Narut Prasitlumkum, Nath Limpruttidham, Pakawat Chongsathidkiet, Wasawat Vutthikraivit, Erin Crossey
BACKGROUND: Fragmented QRS reflects disturbances in the myocardium predisposing the heart to ventricular tachyarrhythmias. Recent studies suggest that fragmented QRS (fQRS) is associated with mortality in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, a systematic review and meta-analysis of the literature has not been done. We assessed the association between fQRS and overall mortality in STEMI patients who subsequently underwent PCI by a systematic review and meta-analysis...
June 22, 2018: Annals of Noninvasive Electrocardiology
Freddy Del-Carpio Munoz, Peter A Noseworthy, S Michael Gharacholou, Christopher G Scott, Vuyisile T Nkomo, Francisco Lopez-Jimenez, Yong-Mei Cha, Thomas M Munger, Paul A Friedman, Samuel J Asirvatham
BACKGROUND: QRS fragmentation (fQRS) during baseline ventricular conduction, a myocardial fibrosis marker, is associated with increased risk of ventricular tachyarrhythmias but may not manifest unless ventricular activation change is provoked. We examined the association of fQRS during right ventricular (RV) pacing with death and ventricular tachyarrhythmia in patients with left ventricular (LV) dysfunction undergoing electrophysiology study (EPS). METHODS AND RESULTS: Study participants had LV dysfunction (ejection fraction < 50%) undergoing EPS from January 2002 to May 2014 at Mayo Clinic in Rochester, Minnesota...
September 2018: Journal of Cardiovascular Electrophysiology
Mehmet Yaman, Ugur Arslan, Adil Bayramoglu, Osman Bektas, Zeki Yuksel Gunaydin, Ahmet Kaya
AIM: The aim of this study was to measure epicardial adipose tissue (EAT) and to assess left ventricular (LV) systolic and diastolic function in a healthy population grouped according to the presence of fragmented QRS (fQRS). METHODS: In this prospective case-control study, the study population consisted of 308 healthy individuals who were divided into two groups according to the existence of fQRS: 180 fQRS(+) individuals (with fQRS), and 128 age- and gender-matched fQRS(-) individuals (without fQRS)...
June 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Cory M Tschabrunn, Haris M Haqqani, Pasquale Santangeli, Erica S Zado, Francis E Marchlinski
OBJECTIVES: The purpose of this study was to evaluate the relationship between electrocardiogram (ECG) QRS fragmentation (fQRS) and right ventricular (RV) endocardial (ENDO) and epicardial (EPI) electroanatomic substrate abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). BACKGROUND: fQRS is frequently observed in patients with ARVC and reflects delayed conduction due to RV fibrosis. METHODS: A total of 30 consecutive patients met the task force criteria for ARVC (19 men, mean age 41...
July 2017: JACC. Clinical Electrophysiology
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