Fragmented QRS Complexes in Cardiac Prognosis
Summary
Fragmented QRS complexes (fQRS) are defined by additional notches or slurs within the standard QRS waveform on a 12-lead electrocardiogram. These irregularities arise from heterogeneous ventricular depolarisation, often reflecting underlying myocardial fibrosis or scarring. As a non-invasive marker, fQRS has been shown to stratify risk across a spectrum of cardiac conditions—ranging from ischaemic heart disease and heart failure to inherited arrhythmia syndromes. Its presence correlates with adverse structural remodelling, impaired electromechanical synchrony and an elevated likelihood of ventricular arrhythmias, sudden cardiac death and hospital readmission. Clinically, fQRS aids in identifying patients who may benefit from closer surveillance, tailored pharmacotherapy or device interventions, and its assessment can be readily incorporated into routine ECG interpretation without additional equipment or training.
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Fragmented QRS Complexes in Cardiac Prognosis publication trend
The graph below shows the total number of articles in fragmented qrs complexes in cardiac prognosis across all publications each year (not limited to Nature Index journals).
Technical terms
Fragmented QRS complex (fQRS): Presence of additional spikes, notches or slurs within the QRS complex on a standard ECG, indicating heterogeneous ventricular conduction often due to myocardial scarring.
QRS micro-fragmentation (QRS-μf): A quantitative measure of subvisible conduction abnormalities obtained by comparing original and optimally reconstructed three-dimensional QRS signals, reflecting subtle depolarisation defects.
Heart failure with preserved ejection fraction (HFpEF): A form of heart failure in which left ventricular ejection fraction remains ≥50%, yet patients exhibit signs of elevated filling pressures and diastolic dysfunction.
References
- QRS Fragmentation in Preserved Ejection Fraction Heart Failure: Functional Insights, Pathological Correlates, and Prognosis. Journal of the American Heart Association (2023).
- QRS micro-fragmentation as a mortality predictor. European Heart Journal (2022).
- Fragmented QRS: What Is The Meaning?. Indian Pacing and Electrophysiology Journal (2012).
- AI-enabled detection of QRS fragmentation from 12-lead electrocardiogram and its clinical relevance for predicting malignant arrhythmia onset. Frontiers in Cardiovascular Medicine (2024).
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