title: Fragmented QRS predicts cardiovascular death of patients with structural heart disease and inducible ventricular tachyarrhythmia.
abstract: BACKGROUND
  Fragmented QRS (fQRS) can predict cardiac events, and inducible ventricular tachycardia/fibrillation (VT/VF) is a known high-risk factor for arrhythmic death. However, whether fQRS is a predictor of cardiac events in patients with inducible VT/VF is unknown. We aimed to evaluate whether fQRS is a predictor of cardiac events in patients with structural heart disease and inducible VT/VF.
  
  
  RESULTS
  We retrospectively investigated 98 patients with structural heart disease who had a defibrillator device implanted. All patients underwent electrophysiological testing prior to or after device implantation and VT/VF was induced. fQRS was present in 30 patients. Appropriate defibrillator therapies were similar between the fQRS and non-fQRS groups (47% vs. 47%). In total, 25 patients (26%) died during a mean follow-up period of 87±43 months. All-cause mortality (12 [40%] vs. 13 [19%]) and cardiovascular deaths (9 [30%] vs. 4 [6%]) were significantly higher in the fQRS group than non-fQRS group, respectively; Kaplan-Meier analysis revealed significantly lower event-free survival for all-cause mortality (P=0.012) and cardiovascular deaths (P=0.001) for fQRS patients. A multivariable Cox regression model revealed that fQRS was an independent predictor of cardiovascular death (hazard ratio, 4.58; 95% confidence interval, 1.34-15.64; P=0.015).
  
  
  CONCLUSIONS
  fQRS is a predictor of cardiovascular death in patients with structural heart disease and inducible VT/VF.
authors: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital.
authors: Takekuni
authors: T
authors: Hayashi
authors: Seiji
authors: S
authors: Fukamizu
authors: Rintaro
authors: R
authors: Hojo
authors: Kota
authors: K
authors: Komiyama
authors: Yasuhiro
authors: Y
authors: Tanabe
authors: Tamotsu
authors: T
authors: Tejima
authors: Mitsuhiro
authors: M
authors: Nishizaki
authors: Masayasu
authors: M
authors: Hiraoka
authors: Junya
authors: J
authors: Ako
authors: Shin-ichi
authors: S
authors: Momomura
authors: Harumizu
authors: H
authors: Sakurada
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D018572:Disease-Free Survival; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy