Fragmented QRS complexes are associated with cardiac fibrosis and significant intraventricular systolic dyssynchrony in nonischemic dilated cardiomyopathy patients with a narrow QRS interval.
BACKGROUND
Myocardial scar causes heterogeneous ventricular activation, which results in fragmentation of QRS complexes on ECG. Myocardial fibrosis in patients with nonischemic cardiomyopathy (NDCM) can be identified as late gadolinium enhancement (LGE) areas on cardiac magnetic resonance (CMR) studies. We investigated the association of fragmented QRS (fQRS) complexes with systolic dyssynchrony and myocardial fibrosis in patients with NDCM.


METHODS
Twenty patients with NDCM and sinus rhythm who had fQRS complexes were evaluated with CMR. The association of fQRS complexes with LGE and systolic dyssynchrony was investigated.


RESULTS
Nineteen patients had significant systolic dyssynchrony with echocardiography. Among 19 patients with significant dyssynchrony, 14 (74%) patients had fQRS complexes in the most delayed contracting segment or one of the dyssynchronous segments, whereas five patients (26%) had fQRS complexes in a lead which is discordant with the dyssynchronous segment on echocardiography. Seventeen patients had LGE in their CMR. Among the 17 patients with LGE; 13 patients (76%) had fQRS complexes concordant with LGE present segments.


CONCLUSIONS
Fragmentation of QRS complexes on ECG is associated with intraventricular systolic dyssynchrony and subendocardial fibrosis in NDCM patients with a narrow QRS interval and sinus rhythm.
Basaran
Yelda
Y
Cardiology Department, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey. mktigen@yahoo.com
Tigen
Kursat
K
Karaahmet
Tansu
T
Isiklar
Iclal
I
Cevik
Cihan
C
Gurel
Emre
E
Dundar
Cihan
C
Pala
Selcuk
S
Mahmutyazicioglu
Kamran
K
Basaran
Ozcan
O
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods*; D004719:Endomyocardial Fibrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography; D008297:Male; D011859:Radiography; D018754:Ventricular Dysfunction / Q000175:diagnosis / Q000000981:diagnostic imaging*