Department of Cardiology, Caen University Hospital, Avenue de la Côte de Nacre, F-14000 Caen, France.
Department of Clinical, Physiology and Sports Medicine, Caen University Hospital, Avenue de la Côte de Nacre, F-14000 Caen, France.
Europace. 2020 Apr 1;22(4):649-656. doi: 10.1093/europace/euaa037.
Limited data exist concerning fragmented QRS complexes (fQRSs) on the surface electrocardiogram (ECG) of apparently healthy athletes. We aimed to study the prevalence and significance of fQRS in lead V1 (fQRSV1), representing right ventricular (RV) activation, regarding training-induced RV morphological remodelling.
Between January 2017 and August 2019, 434 consecutive non-sedentary subjects underwent preparticipation cardiovascular screening, including a 12-lead ECG. Three hundred and ninety-three apparently healthy subjects were included, 119 of them were athletes (defined as performing ≥8 h/week for the last 6 months) and 274 were non-athletes. All athletes underwent two-dimensional transthoracic echocardiography. Fragmented QRS complex in lead V1 pattern was defined as a narrow (<120 ms) and quadriphasic QRS complex in lead V1. Fragmented QRS complex in lead V1 was more frequent in athletes compared with non-athletes (22% vs. 5.1%, P < 0.001) and was independently associated with the athlete status [adjusted odds ratio (aOR) = 4.693, 95% confidence interval (95% CI) 2.299-9.583; P < 0.001], the endurance category (aOR = 2.522, 95% CI 1.176-5.408; P = 0.017), and age (aOR = 0.962, 95% CI 0.934-0.989; P = 0.007) in multivariate analysis. In the subgroup of athletes, fQRSV1 was independently associated with mean RV outflow tract diameter (aOR = 1.458, 95% CI 1.105-1.923; P = 0.008) and age (aOR = 0.941, 95% CI 0.894-0.989; P = 0.017) in multivariate analysis.
Fragmented QRS complex in lead V1 is a newly described, frequent, ECG pattern in young and apparently healthy athletes and is associated with training-induced RV remodelling.
体表心电图（ECG）上有限的碎裂 QRS 波群（fQRS）数据存在于明显健康的运动员中。我们旨在研究代表右心室（RV）激活的导联 V1 中的 fQRS（fQRSV1）的患病率和意义，以及训练诱导的 RV 形态重塑。
2017 年 1 月至 2019 年 8 月，连续 434 名非卧床受试者接受了参赛前心血管筛查，包括 12 导联心电图。393 名明显健康的受试者入选，其中 119 名是运动员（定义为过去 6 个月每周至少运动 8 小时），274 名是非运动员。所有运动员均接受二维经胸超声心动图检查。V1 导联 fQRS 形态定义为 V1 导联中狭窄（<120ms）和四相 QRS 复合波。与非运动员相比，运动员中 fQRSV1 更为常见（22%比 5.1%，P<0.001），且独立于运动员身份相关（校正比值比[aOR]为 4.693，95%置信区间[95%CI]为 2.299-9.583；P<0.001），耐力类别（aOR 为 2.522，95%CI 为 1.176-5.408；P=0.017）和年龄（aOR 为 0.962，95%CI 为 0.934-0.989；P=0.007）。在运动员亚组中，fQRSV1 与 RV 流出道平均直径（aOR 为 1.458，95%CI 为 1.105-1.923；P=0.008）和年龄（aOR 为 0.941，95%CI 为 0.894-0.989；P=0.017）独立相关。
导联 V1 中的碎裂 QRS 波群是一种新描述的、常见的年轻且明显健康的运动员的心电图模式，与训练诱导的 RV 重塑有关。
