title: Fragmentation of the QRS complex in patients with acute coronary syndrome treated invasively.
abstract: BACKGROUND
  Previous studies showed that the presence of fragmented QRS (f-QRS) in patients with acute coronary syndrome (ACS), who underwent complete revascularisation, is associated with worse prognosis and the possibility of arrhythmia occurrence.
  
  
  OBJECTIVE
  To assess the prognostic value of f-QRS in patients with ACS and complete revascularisation, in the context of cardiac ar-rhythmias.
  
  
  METHODS
  We analysed 124 consecutive patients (66.1% males; mean age 62.38 ± 11.0 years) with ACS (STEMI 49%) treated invasively. Based on electrocardiogram (ECG) record, performed during the admission to the clinic, after the complete revascularisation (TIMI = 3) and during discharging from hospital (4th-5th days after ACS), we classified QRS as f-QRS based on generally accepted criteria (QRS < 120 ms, which included an additional R wave [R']) or notching in the nadir of the S wave, or > 1 R' (fragmentation) in two contiguous leads, corresponding to a major coronary artery territory. 24-h Holter ECG recording was performed on the fifth day after ACS to assess the frequency of conduction disturbances and others arrhythmias.
  
  
  RESULTS
  There were no statistically significant differences between patients with and without f-QRS during hospitalisation. In the patients with f-QRS there were no statistically significant conduction disturbances and other arrhythmias compared to patients without f-QRS at discharge.
  
  
  CONCLUSIONS
  In the patients with ACS, who underwent successful revascularisation (TIMI = 3), the presence of f-QRS is not correlated with a higher incidence of arrhythmias compared to patients without f-QRS in short-term follow-up.
authors.forename: Alicja M
authors.initials: AM
authors.lastname: Daszyk
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zygmund
authors.affiliation: 1st Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Medical University of Silesia, Silesian Center of Heart Diseases, Zabrze, Poland. kas-k2@o2.pl.
authors.forename: Katarzyna A
authors.initials: KA
authors.lastname: Mitręga
authors.forename: Sylwia
authors.initials: S
authors.lastname: Cebula
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kalarus
authors.forename: Beata
authors.initials: B
authors.lastname: Średniawa
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000601:surgery*; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis
keywords: acute coronary syndrome; arrhythmias; fragmented QRS complexes