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Prognostic value of QRS fragmentation in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.
- Source :
-
Journal of cardiovascular medicine (Hagerstown, Md.) [J Cardiovasc Med (Hagerstown)] 2012 May; Vol. 13 (5), pp. 295-8. - Publication Year :
- 2012
-
Abstract
- Context: QRS fragmentation, including epsilon potentials, terminal activation delay and prolonged S wave upstroke, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). Whether QRS fragmentation is a marker of recurrent ventricular tachycardia, primary ventricular fibrillation, implantable cardioverter defibrillator (ICD) discharge and sudden cardiac death in these patients is unknown.<br />Results: Three hundred and thirty-five patients (167 men, mean age 46.3 ± 14.6 years) with ARVC/D according to International Society and Federation of Cardiology/European Society of Cardiology (ISFC/ESC) criteria were analyzed retrospectively. Patients with complete and incomplete right bundle branch block were excluded from the analysis. At 6.3 ± 3.1 years mean follow-up, seven patients (0.02%) had died suddenly, 39 patients (0.13%) experienced recurrent ventricular tachycardia, 32 patients (0.1%) presented with primary ventricular fibrillation and 30 patients (0.1%) had recurrent ICD discharges. QRS fragmentation was significantly associated with arrhythmic events (P < 0.0000001 for the endpoint of sudden cardiac death, P < 0.01 for recurrent ventricular tachycardia, P < 0.0001 for primary ventricular fibrillation and P < 0.001 for recurrent ICD discharges, respectively).<br />Conclusion: QRS fragmentation predicts arrhythmic events in patients with ARVC/D. Further, properly designed prospective studies are warranted to confirm these findings.
- Subjects :
- Action Potentials
Adult
Arrhythmogenic Right Ventricular Dysplasia complications
Arrhythmogenic Right Ventricular Dysplasia mortality
Arrhythmogenic Right Ventricular Dysplasia physiopathology
Arrhythmogenic Right Ventricular Dysplasia therapy
Chi-Square Distribution
Death, Sudden, Cardiac etiology
Defibrillators, Implantable
Electric Countershock instrumentation
Female
Germany
Humans
Male
Middle Aged
Predictive Value of Tests
Recurrence
Retrospective Studies
Risk Assessment
Risk Factors
Tachycardia, Ventricular etiology
Tachycardia, Ventricular physiopathology
Time Factors
Treatment Outcome
Ventricular Fibrillation etiology
Ventricular Fibrillation physiopathology
Arrhythmogenic Right Ventricular Dysplasia diagnosis
Electrocardiography
Heart Conduction System physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1558-2035
- Volume :
- 13
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of cardiovascular medicine (Hagerstown, Md.)
- Publication Type :
- Academic Journal
- Accession number :
- 22450866
- Full Text :
- https://doi.org/10.2459/JCM.0b013e32834bed0a