Abstract 18314: Fragmented QRS on a 12-lead ECG: A Predictor of Major Arrhythmic Events and Sudden Cardiac Death in Patients with Hypertrophic Cardiomyopathy; Long-term Follow-up Study
INTRODUCTION Fragmented QRS (fQRS) on a 12-lead electrocardiogram (ECG) is associated with major arrhythmic events (MAEs) included sudden cardiac death (SCD). However, Limited data was still shown in patients with hypertrophic cardiomyopathy (HCM).
METHODS fQRS included various RSRpatterns (QRS duration < 120ms), such as ≥1 R prime or notching of the R wave or S wave present on at least two contiguous leads of those representing anterior (V1-V5), lateral (I, aVL, V6), or inferior (II, III, aVF) myocardial segments on a 12-lead electrocardiogram (ECG). In the 454 (71% male, age 62±11 years, mean follow-up duration 10±1 years) patients with diagnosed HCM using echocardiography. We divided into two groups; fQRS and non-fQRS group at the time of diagnosis. MAEs (sustained VT or non-sustained VT on ambulatory 24-hr holter monitoring) including SCD were retrospectively reviewed.
RESULTS fQRS was found (87/203, 42.8%) and predominantly located in inferior lead, the patients were divided into two groups: Heart rate, PR interval, QRS duration and QTc interval were similar in both groups. MAEs including SCD [14 (31.1%) vs. 2 (2.2%)] were higher in the fQRS group compared with the non-fQRS group (mean follow-up duration, 7.1±2.2 years). Multivariate Cox regression analysis revealed that fQRS was an independent significant predictor for MAE including SCD [hazard ratio 11.09 (confidence interval 2.40-51.09), p=0.002]. A Kaplan-Meier survival analysis revealed that fQRS group was significantly associated with lower MAE-free survival rate compared to non-fQRS group (P=0.004).
CONCLUSION The fQRS complex is an independent predictor of MAEs including SCD in patients with HCM on long-term follow-up.
- © 2012 by American Heart Association, Inc.