Fragmented QRS complex in patients with implantable cardioverter defibrillator-Prevalence and predisposing factors.

BACKGROUND

Incidence of fragmented (fQRS) and predisposing factors in patients with implantable cardioverter-defibrillator (ICD) have not yet been established. Aim To examine incidence of fQRS, associated factors as well as predictive value in identifying site of coronary artery disease (CAD).

METHODS

Consecutive patients with ICD. Retrospective analysis of demographic, clinical and ECG data.

RESULTS

Of 382 patients, 163 (43%) had fQRS. They had more frequently history of MI, Q wave, lower left ventricular ejection fraction and prolonged ECG repolarisation indices. The presence of fQRS in more than one ECG localisation was associated with higher number of MI and ICD for secondary prevention. By combining fQRS with Q wave location, site of CAD could be predicted (total accuracy 84-95%).

CONCLUSIONS

The fQRS is frequent in patients with ICD, especially those with CAD, more advanced cardiac disease and altered ECG repolarisation. The fQRS may improve ECG-based non-invasive identification of the site of CAD.