Fragmented QRS complexes on 12-lead ECG: a marker of cardiac sarcoidosis as detected by gadolinium cardiac magnetic resonance imaging.
BACKGROUND
Fragmented QRS complexes (fQRS) on a 12-lead ECG are a marker of myocardial scar in patients with coronary artery disease. Cardiac sarcoidosis is also associated with myocardial granuloma formation and scarring. We evaluated the significance of fQRS on a 12-lead ECG compared to Gadolinium-delayed enhancement images (GDE) in cardiac magnetic resonance imaging (CMR).


RESULTS
The ECGs of patients (n = 17, mean age: 52 +/- 11 years, male: 53%) with established diagnosis of sarcoidosis who underwent a CMR for evaluation of cardiac involvement were studied. ECG abnormalities included bundle branch block, Q wave, and fQRS. fQRS, Q wave, and bundle branch block were present in 9 (53%), 1 (6%), and 4 (24%) patients, respectively. The sensitivity and specificity of fQRS for detecting abnormal GDE were 100% and 80%, respectively. Sensitivity and specificity of Q waves were 11% and 100%, respectively.


CONCLUSIONS
fQRS on a 12-lead ECG in patients with suspected cardiac sarcoidosis are associated with cardiac involvement as detected by GDE on CMR.
Homsi
Mohamed
M
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Alsayed
Lamaan
L
Safadi
Bilal
B
Mahenthiran
Jo
J
Das
Mithilesh K
MK
D002037:Bundle-Branch Block / Q000175:diagnosis; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis*; D003287:Contrast Media; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D003287:Contrast Media; D005682:Gadolinium