Sadeghi Ramin, Dabbagh Vahid-Reza, Tayyebi Mohammad, Zakavi Seyed Rasoul, Ayati Narjess
Nuclear Medicine Research Center, Mashhad University of Medical Sciences.
Kardiol Pol. 2016;74(4):331-7. doi: 10.5603/KP.a2015.0193. Epub 2015 Sep 28.
The present study aimed to investigate the diagnostic value of fragmented QRS complex (fQRS) on 12-lead electrocardiogram (ECG) for myocardial scar detection, and presented the results in a systematic review and meta-analysis format.
Medline, SCOPUS, and ISI Web of Knowledge were searched electronically with "Fragmented QRS" or "fQRS" as key words. All related studies that had evaluated the accuracy of fQRS for myocardial scar diagnosis were included.
Eight studies (2560 patients) were finally included in the systematic review. Specificity assessment could be evaluated only by five out of these eight articles. Overall pooled sensitivity of fQRS, Q wave, and mixed Q-fQRS was 68% (65-71), 51% (47-55), and 74% (69-79) and the pooled specificity was 80% (79-81), 97% (97-98) and 92% (91-93), respectively.
Fragmented QRS is a novel ECG marker with more sensitivity and less specificity than Q wave. A combination of fQRS with Q wave in a 12-lead ECG results in up to 74% sensitivity and 92% specificity. Additional studies are needed to assess the significance of this ECG parameter for regional myocardial scar detection.
本研究旨在探讨12导联心电图（ECG）上碎裂QRS波群（fQRS）对心肌瘢痕检测的诊断价值，并以系统评价和荟萃分析的形式呈现结果。
以“Fragmented QRS”或“fQRS”为关键词，通过电子检索Medline、SCOPUS和ISI Web of Knowledge。纳入所有评估fQRS对心肌瘢痕诊断准确性的相关研究。
最终8项研究（2560例患者）纳入系统评价。这8篇文章中仅有5篇可进行特异性评估。fQRS、Q波和混合Q-fQRS的总体合并敏感性分别为68%（65-71）、51%（47-55）和74%（69-79），合并特异性分别为80%（79-81）、97%（97-98）和92%（91-93）。
碎裂QRS是一种新型心电图标志物，与Q波相比，敏感性更高，特异性更低。12导联心电图中fQRS与Q波联合使用时，敏感性可达74%，特异性可达92%。需要进一步研究评估该心电图参数对局部心肌瘢痕检测的意义。
