title: Absence and Resolution of Fragmented QRS Predict Reversible Myocardial Ischemia With Higher Probability of ST Segment Resolution in Patients With ST Segment Elevation Myocardial Infarction.
abstract: OBJECTIVE
  Fragmented QRS complexes (fQRS) are associated with increased morbidity and mortality. The causative relationship between fQRS and cardiac fibrosis has been shown, but whether the presence and the number of fQRS on admission of electrocardiogram (ECG) predicts ST segment resolution in patients undergoing primary percutaneous coronary intervention (p-PCI) has not been investigated until now.
  
  
  METHODS
  This study included one hundred and eighty-four consecutive patients with ST elevation myocardial infarction (STEMI) who underwent p-PCI. The presence or absence of fQRS on pre and post-PCI ECG and their relation with myocardial infarction and reperfusion parameters were investigated.
  
  
  RESULTS
  Patients with fQRS on admission of ECG or newly developed fQRS after p-PCI had increased inflammatory markers, higher cardiac enzyme levels, increased pain to balloon time, prolonged QRS time, more extended coronary involvement and more frequent Q waves on ECG in comparison to patients with absence or resolved fQRS. The presence and higher number of fQRS on admission or post-PCI ECGs were significantly related with low percent of ST resolution and myocardial reperfusion parameters. The area under the receiver operating characteristics curve values for the presence and number of fQRS to detect Thrombolysis in Myocardial Infarction Blush Grade 0 and 1, were 0.682 and 0.703.
  
  
  CONCLUSIONS
  In our study, fQRS was significantly related to infarction and myocardial reperfusion parameters before and after p-PCI. Successful myocardial reperfusion by p-PCI caused the reduction in number of fQRS and QRS time with higher ST resolution. fQRS may be useful in identifying the patients at higher cardiac risk with increased ischemic jeopardized or infarcted myocardium, and persistent or newly developed fQRS may predict low percent of ST segment resolution in patients undergoing p-PCI.
authors.affiliation: Department of Cardiology, Rize Education and Research Hospital, Rize, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Sinan Altan
authors.initials: SA
authors.lastname: Kocaman
authors.forename: Tuncay
authors.initials: T
authors.lastname: Kiris
authors.forename: Turan
authors.initials: T
authors.lastname: Erdogan
authors.forename: Aytun
authors.initials: A
authors.lastname: Canga
authors.forename: Murtaza Emre
authors.initials: ME
authors.lastname: Durakoglugil
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Ciçek
authors.forename: Sitki
authors.initials: S
authors.lastname: Dogan
authors.forename: Omer
authors.initials: O
authors.lastname: Satiroglu