Baseline fragmented QRS increases the risk of major arrhythmic events in hypertrophic cardiomyopathy: Systematic review and meta‐analysis

• Published in: Annals of noninvasive electrocardiology Vol. 23; no. 4; pp. e12533 - n/a
• Main Authors: Rattanawong, Pattara, Riangwiwat, Tanawan, Kanitsoraphan, Chanavuth, Chongsathidkiet, Pakawat, Kanjanahattakij, Napatt, Vutthikraivit, Wasawat, Chung, Eugene H.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.07.2018; John Wiley and Sons Inc
• Subjects: Arrhythmias, Cardiac - complications; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - physiopathology; Cardiomyopathy; Cardiomyopathy, Hypertrophic - complications; Cardiomyopathy, Hypertrophic - diagnosis; Cardiomyopathy, Hypertrophic - physiopathology; Confidence intervals; Death, Sudden, Cardiac - etiology; Defibrillators; Electrocardiography - methods; Electrocardiography - statistics & numerical data; Fragmentation; fragmented QRS; Heart; Humans; hypertrophic cardiomyopathy; Literature reviews; major arrhythmic events; Meta-analysis; Myocardium; Original; Risk Assessment; Risk Factors; Systematic review; Tachycardia; Ventricle; major arrhythmic events; hypertrophic cardiomyopathy; fragmented QRS
• ISSN: 1082-720X; 1542-474X; 1542-474X
• DOI: 10.1111/anec.12533

Background Fragmented QRS reflects disturbances in the myocardium predisposing the heart to ventricular tachyarrhythmias. Recent studies suggest that fragmented QRS (fQRS) is associated with worse major arrhythmic events in hypertrophic cardiomyopathy (HCM). However, a systematic review and meta‐analysis of the literature has not been done. We assessed the association between fQRS and major arrhythmic events in hypertrophic cardiomyopathy by a systematic review of the literature and a meta‐analysis. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to May 2017. Included studies were published prospective or retrospective cohort studies that compared major arrhythmic events (sustained ventricular tachycardia, sudden cardiac arrest, or sudden cardiac death) in HCM with fQRS versus non‐fQRS. Data from each study were combined using the random‐effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. Results Five studies from January 2013 to May 2017 were included in this meta‐analysis involving 673 subjects with HCM (205 fQRS and 468 non‐fQRS). Fragmented QRS was associated with major arrhythmic events (pooled risk ratio = 7.29, 95% confidence interval: 4.00–13.29, p < .01, I2 = 0%). Conclusion Baseline fQRS increased major arrhythmic events up to sevenfold. Our study suggests that fQRS could be an important tool for risk assessment in patients with HCM.