Fragmented QRS complex and ventricular arrhythmias in patients with myocardial infarction

Aim In our study we aimed to determine whether fragmented wave in electrocadiogram (QRS) (fQRS) is associated with increased incidence of ventricular arrhythmias in patients with coronary artery disease (CAD) or not. Methods 300 patients with CAD were included. Patients were divided into two groups according to presence or absence of fQRS on admission ECG. Group I ( n =51) was defined as fQRS (+ve) and group II ( n =249) was defined as a fQRS (-ve). All patients were subjected to full history taking, complete physical examination, and ECG, echocardiography and laboratory investigations. Results There was higher incidence of fQRS in hypertensive patients (72.5 %). FQRS was found to be associated with increased incidence of ventricular arrhythmias, 51.1 % in group I versus 25% in group II. EF was significantly lower in group I than in group II with P value <0.0001. Fragmented QRS was an independent predictor of mortality with P value <0.0001. Conclusion FQRS on the resting surface electrocardiogram is a simple, fast and inexpensive modality of noninvasive investigation for evaluation of CAD patients. Patients who have known CAD present with a FQRS have increased rates of ventricular tachyarrhythmias, death risk, and low ejection fraction.