Abstract 17162: Prevalence and Long-Term Prognosis of Fragmented Qrs in Standard 12-Lead Electrocardiogram in Middle-Aged Subjects
Introduction. QRS-complex fragmentation (fQRS), defined as changes in QRS-morphology with various RSR’-patterns, has been recently associated with increased mortality and arrhythmic events in several cardiac conditions. However, the prevalence and prognostic significance of fQRS in general population are not known.
Methods. We evaluated the 12-lead ECGs of 10899 Finnish middle-aged subjects (52% males, mean age 44±8.5 years) drawn from general population and followed for 30±11 years. fQRS was defined as R’ or S-wave upstroke notching within QRS-complex in two consecutive leads in the same major coronary artery territory (inferior II, III, aVF; lateral I, aVL, V4-V6; anterior V1-V3). Primary endpoint was cardiovascular death.
Results. fQRS was present in 19.2% of subjects, including 16.4% in inferior leads, 1.1% in lateral leads, and 3.3% in anterior leads. A total of 8 (0.07%) subjects had fQRS in all territories. fQRS was more common in males than in females (p<0.001) and subjects with fQRS were somewhat older than those without (p<0.001). fQRS in any location was associated with increased cardiovascular mortality (hazard ratio 1.19, 95% confidence interval 1.07-1.33). In further analyses, fQRS in lateral leads predicted cardiac death even after adjustments for age and gender (adjusted-HR 1.65, 95%CI 1.18-2.33). Inferior or anterior manifestations were not associated with increased risk after adjustments. Additionally, higher mortality rates were not observed in subjects with fQRS in all territories.
Conclusion. fQRS is a common finding especially in the inferior leads of a standard 12-lead ECG in middle-aged subjects. The presence of fQRS in lateral leads is associated with an increased risk of cardiovascular mortality.
- © 2012 by American Heart Association, Inc.