Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging

Background: Fragmented QRS (FQRS) on ECG is associated with the presence of myocardial scar tissue and may have prognostic value after certain ischemic events. We aimed to examine the anatomical correlation of FQRS with the presence of perfusion abnormalities in patients with suspected CAD.Methods: Patients with a known history of CAD, who were referred for MPI between January 2016 and May 2016 were enrolled. Presence of FQRS on ECG was evaluated. Presence of FQRS, number of leads with FQRS and the location of FQRS as well as patients’ characteristics were compared in patients with normal and abnormal MPI. Multivariate model was constructed to identify independent factors associated with perfusion defect.Results: One hundred four women and 94 men were enrolled. Fragmentation of anterior, lateral and inferior leads was detected in 13 (60.5%), 17 (8.5%) and 36 (18.1%)subjects, respectively. MPI was normal in 134 (67.6%) patients. FQRS was significantly more common in patients with abnormal MPI (p<0.01).Conclusion: In the absence of known CAD, FQRS is associated with the presence of perfusion abnormalities. Incorporating FQRS in diagnostic armamentarium may aid us in selecting patients who may benefit from MPI.

Fragmented QRS on surface electrocardiogram as a predictor of perfusion defect in patients with suspected coronary artery disease undergoing myocardial perfusion imaging Keywords:

Electrocardiogram , myocardial perfusion imaging , fragmented QRS , coronary artery disease