Fragmented QRS as a risk marker for the occurrence of ventricular fibrillation in patients with variant angina.

Autor: Shinohara T; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Yonezu K; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Hirota K; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Kondo H; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Fukui A; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Akioka H; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Teshima Y; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Yufu K; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Nakagawa M; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan., Takahashi N; Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan.
Jazyk: angličtina
Zdroj: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc [Ann Noninvasive Electrocardiol] 2022 May; Vol. 27 (3), pp. e12937. Date of Electronic Publication: 2022 Feb 16.
DOI: 10.1111/anec.12937
Abstrakt: Background: Variant angina (VA) is caused by reversible coronary artery spasm, which is characterized by chest pain with ST-segment elevations on standard 12-lead electrocardiogram (ECG) at rest. Ventricular fibrillation (VF) is often caused by VA attack, but the risk stratification is not well understood. The purpose of this study was to evaluate the impact of fragmented QRS (fQRS) on VF occurrence in VA patients.
Methods: Ninety-four patients who showed ST elevation on 12-lead ECGs with total or nearly total occlusion in response to coronary spasm provocation test were enrolled. Among them, 16 patients had documented VF before hospital admission (n = 12) or experienced VF during provocation test (n = 4) (VF occurrence group). The fQRS was defined as the presence of spikes within the QRS complex of two or more consecutive leads.
Results: The prevalence of fQRS was more often observed in the VF occurrence group than in the non-VF occurrence group (63% [10/16] vs. 27% [21/78], p = 0.009). Univariate analyses revealed that age, history of syncope, QTc, and the presence of fQRS were associated with VF occurrence (p = 0.004, 0.005, 0.029, and 0.008, respectively). Furthermore, upon multivariate analyses using those risk factors, age, QTc, and fQRS predicted VF occurrence independently (p = 0.007, 0.041, and 0.014, respectively).
Conclusions: The present study demonstrated that fQRS in VA patients is a risk factor for VF. The fQRS may be a useful factor for the risk stratification of VF occurrence in VA patients.
(© 2022 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
Externí odkaz: