Attachaipanich Tanawat, Attachaipanich Suthinee, Kaewboot Kotchakorn
Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA, 64110.
Graduate School of Science, Osaka University, Osaka, 565-0871, Japan.
Indian Heart J. 2025 May-Jun;77(3):142-150. doi: 10.1016/j.ihj.2025.04.003. Epub 2025 Apr 10.
Ventricular arrhythmia is an important cause of death in myocardial infarction (MI). Fragmented QRS (fQRS) is an ECG pattern reflecting the inhomogeneity of ventricular conduction and has been demonstrated to be a predictor of arrhythmia in several cardiac conditions. This study aimed to evaluate the prognostic impact of fQRS on arrhythmias in MI patients.
A systematic search was conducted using 4 databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to July 20, 2024. The inclusion criteria were studies that included MI patients and compared the rate of in-hospital arrhythmia between fQRS and non-fQRS participants.
A total of 14 studies were included in this meta-analysis, involving 4566 participants. The presence of fQRS was associated with a higher incidence of ventricular tachycardia (VT) and ventricular fibrillation (VF) compared to non-fQRS, with an odds ratio (OR) of 2.96 (95 %CI 2.00 to 4.39), p < 0.01. Similarly, fQRS was associated with a higher risk of VT, with an OR of 3.59 (95 %CI 1.66 to 7.80), p < 0.01. Although the presence of fQRS did not significantly increase the risk of VF compared to non-fQRS, a sensitivity analysis that excluded a study with serious risk of bias showed that the presence of fQRS was associated with an increased risk of VF, with an OR of 2.45 (95 %CI 1.38 to 4.35), p < 0.01.
The presence of fQRS was associated with a higher risk of in-hospital arrhythmia in MI patients. The fQRS is a potential tool for risk stratification in MI patients for arrhythmia.
室性心律失常是心肌梗死（MI）患者死亡的重要原因。碎裂QRS波（fQRS）是一种反映心室传导不均一性的心电图模式，已被证明是多种心脏疾病中心律失常的预测指标。本研究旨在评估fQRS对MI患者心律失常的预后影响。
使用4个数据库（包括PubMed、Embase、Web of Science和Cochrane CENTRAL）进行系统检索，检索时间从建库至2024年7月20日。纳入标准为纳入MI患者并比较fQRS组和非fQRS组患者院内心律失常发生率的研究。
本荟萃分析共纳入14项研究，涉及4566名参与者。与非fQRS相比，fQRS的存在与室性心动过速（VT）和心室颤动（VF）的发生率较高相关，优势比（OR）为2.96（95%CI 2.00至4.39），p<0.01。同样，fQRS与VT风险较高相关，OR为3.59（95%CI 1.66至7.80），p<0.01。尽管与非fQRS相比，fQRS的存在并未显著增加VF风险，但一项排除有严重偏倚风险研究的敏感性分析表明，fQRS的存在与VF风险增加相关，OR为2.45（95%CI 1.38至4.35），p<0.01。
fQRS的存在与MI患者院内心律失常风险较高相关。fQRS是MI患者心律失常风险分层的潜在工具。
