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.
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Mohamed
M
Homsi
Lamaan
L
Alsayed
Bilal
B
Safadi
Jo
J
Mahenthiran
Mithilesh K
MK
Das
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