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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| Language: | English |
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Elsevier
2025-08-01
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| Series: | Heart Rhythm O2 |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501825001643 |
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| author | Kasin Viriyanukulvong, MD, MSc Nonthikorn Theerasuwipakorn, MD, MSc Wanwarang Wongcharoen, MD Paisit Kosum, MD, MSc Ronpichai Chokesuwattanaskul, MD, MSc |
| author_facet | Kasin Viriyanukulvong, MD, MSc Nonthikorn Theerasuwipakorn, MD, MSc Wanwarang Wongcharoen, MD Paisit Kosum, MD, MSc Ronpichai Chokesuwattanaskul, MD, MSc |
| author_sort | Kasin Viriyanukulvong, MD, MSc |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-d02c15a145d143f29b7c08f6d50d1fd8 |
| institution | Kabale University |
| issn | 2666-5018 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heart Rhythm O2 |
| spelling | doaj-art-d02c15a145d143f29b7c08f6d50d1fd82025-08-24T05:14:44ZengElsevierHeart Rhythm O22666-50182025-08-01681175118110.1016/j.hroo.2025.05.014Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imagingKasin Viriyanukulvong, MD, MSc0Nonthikorn Theerasuwipakorn, MD, MSc1Wanwarang Wongcharoen, MD2Paisit Kosum, MD, MSc3Ronpichai Chokesuwattanaskul, MD, MSc4Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDivision of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, ThailandDivision of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Address reprint requests and corresponding author: Ronpichai Chokesuwattanaskul, Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and Center of Excellence in Arrhythmia Research, Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.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.http://www.sciencedirect.com/science/article/pii/S2666501825001643Cardiac magnetic resonanceElectrocardiogramFragmented QRSLow-pass filterMyocardial scar |
| spellingShingle | Kasin Viriyanukulvong, MD, MSc Nonthikorn Theerasuwipakorn, MD, MSc Wanwarang Wongcharoen, MD Paisit Kosum, MD, MSc Ronpichai Chokesuwattanaskul, MD, MSc Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging Heart Rhythm O2 Cardiac magnetic resonance Electrocardiogram Fragmented QRS Low-pass filter Myocardial scar |
| title | Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging |
| title_full | Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging |
| title_fullStr | Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging |
| title_full_unstemmed | Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging |
| title_short | Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging |
| title_sort | diagnostic performance of the fragmented qrs complex on electrocardiogram for detecting myocardial scars assessed by 3 0 tesla cardiac magnetic resonance imaging |
| topic | Cardiac magnetic resonance Electrocardiogram Fragmented QRS Low-pass filter Myocardial scar |
| url | http://www.sciencedirect.com/science/article/pii/S2666501825001643 |
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