Fragmented QRS and ejection fraction in heart failure patients admitted to the hospital

• Published in: International journal of cardiology. Heart & vasculature Vol. 9; no. C; pp. 11 - 14
• Main Authors: Alattar, Fadi, Imran, Nashat, Shamoon, Fayez
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 07.12.2015; Elsevier
• Subjects: Congestive heart failure; ECG; Ejection fraction; Fragmented QRS; ECG; Congestive heart failure; Fragmented QRS; Ejection fraction
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2015.07.003

Fragmented QRS (FQRS) in 12 lead ECG was recently correlated with various outcomes in ischemic and non-ischemic heart disease. We studied the relationship between FQRS and ejection fraction (EF) in heart failure patients with QRS<120ms. Medical records and echocardiograms of 339 patients admitted with CHF were reviewed. ECGs were read twice by a reader blinded to all data. 70 patients with wide QRS were excluded; 63 patients had FQRS and 206 patients did not have FQRS. FQRS group were more likely to be black (OR=2.17; p=0.0093), and diabetic (OR=1.79; p=0.0451). ROC curve analysis revealed a significant relationship between EF and FQRS (p=0.002). At EF of 48%, OR for FQRS was 4.36 (95% CI: 2.1–9.05; p<.0001). Adjustment for race and diabetes did not change the OR, or confidence intervals (Adjusted OR for race: 4.08 (95% CI: 1.06–15.67; p=0.04); for diabetes: 4.13 (95% CI: 1.46–11.69; p=0.008)). There was a significant difference in EF between patients with FQRS involving ≥2 ECG areas and non-FQRS group (p<0.05), but not between patients with ≥2 vs. one area, or 1 area vs. non-FQRS. In heart failure patients with QRS<120ms, FQRS was observed more frequently in persons of black race and in diabetics and was associated with lower EF. This was mainly seen in patients with FQRS involving ≥2 ECG areas.