Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review
Ventricular depolarization refers to the electrical activation and subsequent contraction of the ventricles, visible as the QRS complex on a 12-lead electrocardiogram (ECG). A well-organized and efficient depolarization is critical for cardiac function. Abnormalities in ventricular depolarization ma...
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IMR Press
2025-01-01
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| Series: | Reviews in Cardiovascular Medicine |
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| Online Access: | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25921 |
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| author | Maarten Blondeel Tomas Robyns Rik Willems Bert Vandenberk |
| author_facet | Maarten Blondeel Tomas Robyns Rik Willems Bert Vandenberk |
| author_sort | Maarten Blondeel |
| collection | DOAJ |
| description | Ventricular depolarization refers to the electrical activation and subsequent contraction of the ventricles, visible as the QRS complex on a 12-lead electrocardiogram (ECG). A well-organized and efficient depolarization is critical for cardiac function. Abnormalities in ventricular depolarization may indicate various pathologies and can be present in all leads if the condition is general, or in a subgroup of anatomically contiguous leads if the condition is limited to the corresponding anatomic location of the heart. Furthermore, the assessment of depolarization abnormalities on the ECG may either be identified visually or this may depend on further processing. In recent decades, assessment of depolarization abnormalities has received a lot of attention for cardiac risk stratification. This risk stratification aims to identify patients at high risk of adverse cardiac events, to tailor preventive or therapeutic interventions. In this review, we provide an oversight of different techniques for assessing abnormal ventricular depolarization and their value in diagnosing certain conditions, in risk stratification of adverse events, and in guiding therapeutic decisions. This includes QRS alterations directly corresponding to cardiac conditions, such as bundle branch blocks, or the presence of a delta wave, and also metrics aiming to qualitatively or quantitatively assess myocardial scarring, such as QRS (micro)fragmentation and QRS-scoring, and techniques assessing abnormal late depolarizations, such as signal-averaged ECG. While most established assessments of abnormal depolarization rely on human interpretation and are limited by visual detection, recently introduced analyses, such as QRS micro-fragmentation, aim to tackle these limitations. Besides eliminating bias, these automated analyses bypass the need for human interpretation, thereby paving the way for large population studies. |
| format | Article |
| id | doaj-art-60604b4eed3e4f888058dc1edb3bec14 |
| institution | Kabale University |
| issn | 1530-6550 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | IMR Press |
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| series | Reviews in Cardiovascular Medicine |
| spelling | doaj-art-60604b4eed3e4f888058dc1edb3bec142025-01-25T10:41:20ZengIMR PressReviews in Cardiovascular Medicine1530-65502025-01-012612592110.31083/RCM25921S1530-6550(24)01601-6Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative ReviewMaarten Blondeel0Tomas Robyns1Rik Willems2Bert Vandenberk3Department of Cardiovasculair Sciences, KU Leuven, 3000 Leuven, BelgiumDepartment of Cardiovasculair Sciences, KU Leuven, 3000 Leuven, BelgiumDepartment of Cardiovasculair Sciences, KU Leuven, 3000 Leuven, BelgiumDepartment of Cardiovasculair Sciences, KU Leuven, 3000 Leuven, BelgiumVentricular depolarization refers to the electrical activation and subsequent contraction of the ventricles, visible as the QRS complex on a 12-lead electrocardiogram (ECG). A well-organized and efficient depolarization is critical for cardiac function. Abnormalities in ventricular depolarization may indicate various pathologies and can be present in all leads if the condition is general, or in a subgroup of anatomically contiguous leads if the condition is limited to the corresponding anatomic location of the heart. Furthermore, the assessment of depolarization abnormalities on the ECG may either be identified visually or this may depend on further processing. In recent decades, assessment of depolarization abnormalities has received a lot of attention for cardiac risk stratification. This risk stratification aims to identify patients at high risk of adverse cardiac events, to tailor preventive or therapeutic interventions. In this review, we provide an oversight of different techniques for assessing abnormal ventricular depolarization and their value in diagnosing certain conditions, in risk stratification of adverse events, and in guiding therapeutic decisions. This includes QRS alterations directly corresponding to cardiac conditions, such as bundle branch blocks, or the presence of a delta wave, and also metrics aiming to qualitatively or quantitatively assess myocardial scarring, such as QRS (micro)fragmentation and QRS-scoring, and techniques assessing abnormal late depolarizations, such as signal-averaged ECG. While most established assessments of abnormal depolarization rely on human interpretation and are limited by visual detection, recently introduced analyses, such as QRS micro-fragmentation, aim to tackle these limitations. Besides eliminating bias, these automated analyses bypass the need for human interpretation, thereby paving the way for large population studies.https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25921electrocardiographyarrhythmiasventricular depolarizationrisk stratificationsudden cardiac deathqrs complexqrs fragmentationqrs scoringr-wave heterogeneitysignal-averaged ecg |
| spellingShingle | Maarten Blondeel Tomas Robyns Rik Willems Bert Vandenberk Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review Reviews in Cardiovascular Medicine electrocardiography arrhythmias ventricular depolarization risk stratification sudden cardiac death qrs complex qrs fragmentation qrs scoring r-wave heterogeneity signal-averaged ecg |
| title | Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review |
| title_full | Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review |
| title_fullStr | Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review |
| title_full_unstemmed | Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review |
| title_short | Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification — A Narrative Review |
| title_sort | ventricular depolarization abnormalities and their role in cardiac risk stratification a narrative review |
| topic | electrocardiography arrhythmias ventricular depolarization risk stratification sudden cardiac death qrs complex qrs fragmentation qrs scoring r-wave heterogeneity signal-averaged ecg |
| url | https://www.imrpress.com/journal/RCM/26/1/10.31083/RCM25921 |
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