title: [Fragmented QRS. Relevance in clinical practice].
abstract: The QRS complex represents the electrical depolarization of ventricular myocardium. In the case of an undisturbed depolarization, the QRS complex has a normal configuration and duration, but abnormal electrical conduction leads to widening of the QRS complex. The block of one of the Tawara branches results in a typical bundle branch block pattern. A QRS complex that cannot be classified as bundle branch block due to an atypical configuration and contains notched R or S waves is called a fragmented QRS. The underlying pathophysiologies are manifold and include myocardial scars induced by ischemic heart disease, myocardial fibrosis due to other diseases, primary cardiac pathologies as well as systemic diseases with cardiac involvement. Pathologies on the cellular level, such as ion channel dysfunctions, also correlate with fragmented QRS. Besides the diagnostic relevance, fragmented QRS is known to have prognostic properties, for example in identifying high risk patients with coronary artery disease, cardiomyopathy, Brugada syndrome and acquired long QT syndrome; however, fragmented QRS may also be detected in ECGs of healthy individuals.
authors.affiliation: I. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland, alexander.steger@tum.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Steger
authors.forename: Daniel
authors.initials: D
authors.lastname: Sinnecker
authors.forename: Anna
authors.initials: A
authors.lastname: Berkefeld
authors.forename: Alexander
authors.initials: A
authors.lastname: Müller
authors.forename: Josef
authors.initials: J
authors.lastname: Gebhardt
authors.forename: Michael
authors.initials: M
authors.lastname: Dommasch
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Huster
authors.forename: Petra
authors.initials: P
authors.lastname: Barthel
authors.forename: Georg
authors.initials: G
authors.lastname: Schmidt
mesh_terms: D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D017682:Myocardial Stunning / Q000150:complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity