Relationship between fragmented QRS and paradoxical septal motion in coronary artery bypass graft patients.
OBJECTIVE
Paradoxical septal motion (PSM) can cause confusion in the assessment of ventricular function with scintigraphy even in the absence of ventricular septal damage and ischemia. Fragmented QRS (fQRS) is associated with various cardiac disorders. In this study, we aimed to determine the correlation between paradoxical septal motion and fQRS after coronary artery bypass grafting (CABG).


METHODS
We retrospectively reviewed the hospital records showing scintigraphic images and electrocardiograms (ECG) of the patients who had undergone CABG. The patients were classified based on the evaluation of motion and thickening of the septal wall. The patients with regular thickening of the septal wall and abnormal motion were classified as PSM (+) group. The patients with normal motion and thickening of the septal wall were classified as PSM (-) group. fQRS complexes are defined as various RSR patterns either with or without Q-waves on a 12-lead resting ECG.


RESULTS
PSM was found to be more common in fQRS patients (p < 0.001). PSM was seen in 91.4 % of cases with fQRS and in 79.8 % of cases without fQRS. No significant differences were found in the phase analysis parameters. A correlation was found between septal wall motion values and the presence of fQRS (r = 0.197, p = 0.012).


CONCLUSIONS
fQRS was associated with PSM. fQRS may cause PSM in patients with CABG without left bundle branch block due to a conduction defect. PSM and fQRS are predictive of cardiac mortality. Patients diagnosed with PSM and fQRS, should be monitored closely.
Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, 17110, Çanakkale, Turkey. ahmetbarutcu@comu.edu.tr.
Ahmet
A
Barutçu
Department of Nuclear Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. semozdemir@yahoo.com.
Semra
S
Ozdemir
Department of Nuclear Medicine, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. yziyatan@yahoo.com.
Yusuf Ziya
YZ
Tan
Department of Cardiovascular Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. yener@comu.edu.tr.
Ali Ümit
AÜ
Yener
Department of Cardiovascular Surgery, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey. sedatozcan78@hotmail.com.
Sedat
S
Özcan
Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, 17110, Çanakkale, Turkey. eordulu@hotmail.com.
Emine
E
Gazi
D000368:Aged; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009068:Movement; D055414:Myocardial Perfusion Imaging / Q000379:methods; D009929:Organ Size; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
Coronary artery bypass graft; Fragmented QRS; Paradoxical septal motion