Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging

Background: Fragmented QRS complex (f-QRS) on a 12-lead electrocardiogram (ECG) has been associated with myocardial scars. However, its diagnostic accuracy for detecting myocardial scars assessed by cardiac magnetic resonance (CMR) imaging remains uncertain. Objective: To evaluate the diagnostic per...

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Main Authors: Kasin Viriyanukulvong, MD, MSc, Nonthikorn Theerasuwipakorn, MD, MSc, Wanwarang Wongcharoen, MD, Paisit Kosum, MD, MSc, Ronpichai Chokesuwattanaskul, MD, MSc
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Heart Rhythm O2
Subjects:
Cardiac magnetic resonance
Electrocardiogram
Fragmented QRS
Low-pass filter
Myocardial scar
Online Access:http://www.sciencedirect.com/science/article/pii/S2666501825001643
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Summary:Background: Fragmented QRS complex (f-QRS) on a 12-lead electrocardiogram (ECG) has been associated with myocardial scars. However, its diagnostic accuracy for detecting myocardial scars assessed by cardiac magnetic resonance (CMR) imaging remains uncertain. Objective: To evaluate the diagnostic performance of f-QRS for detecting myocardial scars assessed by 3.0 CMR. Methods: Patients who underwent 3.0 Tesla CMR between May 2020 and May 2023 were included. A 12-lead ECG was assessed for f-QRS, defined as the presence of an R' wave or notching in the nadir of the S wave in at least 2 contiguous leads. The diagnostic performance of f-QRS in detecting myocardial scars in corresponding left ventricular segments was analyzed. Results: Overall, 1692 patients were included. f-QRS presented in 826 (49%) participants which were more prevalent in men (59.4% vs 46.0%), those with a history of coronary artery disease (26.4% vs 20.6%), and those with myocardial scars (48.9% vs 37.3). The sensitivity and specificity of f-QRS from ECG were 25.6% and 88.7% for anterior; 22.1% and 91.5%, for lateral; and 42.9% and 63.4% for inferior segments. Conclusion: f-QRS demonstrates high specificity for detecting myocardial scars on CMR, though its sensitivity is limited.
ISSN:2666-5018

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