植入式心脏复律除颤器患者的碎裂QRS波群——患病率及易感因素
Fragmented QRS complex in patients with implantable cardioverter defibrillator-Prevalence and predisposing factors.
作者信息
Kucharz Anna, Kułakowski Piotr
机构信息
Department of Cardiology, Saint Vincent a Paulo Hospital, 81-348 Gdynia, ul. Wójta Radtkego 1, Poland.
Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, 04-073 Warsaw, ul. Grenadierów 51/59, Poland.
出版信息
J Electrocardiol. 2018 Sep-Oct;51(5):913-919. doi: 10.1016/j.jelectrocard.2018.07.014. Epub 2018 Jul 19.
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.
背景
植入式心脏复律除颤器（ICD）患者中碎裂QRS波（fQRS）的发生率及相关因素尚未明确。目的：研究fQRS的发生率、相关因素及其在识别冠状动脉疾病（CAD）部位方面的预测价值。
方法
连续纳入ICD患者。对人口统计学、临床和心电图数据进行回顾性分析。
结果
382例患者中，163例（43%）有fQRS。他们更常有心梗病史、Q波、较低的左心室射血分数和延长的心电图复极指标。多个心电图定位出现fQRS与更多的心梗次数及二级预防ICD相关。通过将fQRS与Q波位置相结合，可预测CAD部位（总准确率84 - 95%）。
结论
fQRS在ICD患者中常见，尤其是CAD、更严重心脏病和心电图复极改变的患者。fQRS可能改善基于心电图的CAD部位无创识别。
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