Fragmented QRS; as a new sign on ecg for pre-diagnosis of non-st elevation myocardial infarction
Ertan Ararat1, Nalan Kozaci2, Mustafa Avci2, Erkan Koklu3
1Usak University Education and Research Hospital; Department of Emergency Medicine, Usak, Turkey
2Antalya Education and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
3Antalya Education and Research Hospital, Department of Cardiology, Antalya, Turkey
Aim: The aim of this study is to evaluate the predictive value of fragmented QRS (fQRS) wave to detect non-ST elevation myocardial infarction (Non-STEMI).
Material and Methods: The study included patients who were diagnosed with Non-STEMI in emergency department and underwent percutaneous coronary intervention in the cardiology clinic. Coronary artery circulation is anatomically divided as the left anterior descending coronary artery (LAD) (V1-V5), the left Circumflex (LCx) (I, aVL and V5,V6) and the right coronary artery (RCA) (II, III and aVF).
Results: Our study included 191 patients. Significant fQRS was detected in 139 (%73) patients and ST/T was detected in 79 (%41) patients. The sensitivity, specificity, of fQRS in the inferior leads to predict RCA lesionwas 76%, 46%, respectively. The sensitivity, specificity, of ST/T in the inferior leads to “predict RCA lesion was 12%, 93%, respectively. The sensitivity, specificity of fQRS in the lateral leads to predict LCx lesion were 44% and 83%, respectively. The sensitivity, specificity of ST/T in the lateral leads to predict LCx lesion were 34%, 74%, respectively. The sensitivity, specificity of fQRS in the anterior leads to predict left LAD lesion were 34% and 82%, respectively. The sensitivity, specificity of ST/T in the anterior leads to predict LAD lesion were 38%, and 81%, respectively.
Conclusion: We have compared to fQRS and ST/T on ECG; fQRS has higher sensitivity than ST/T to predict culprit coronary artery lesion. Therefore, evaluation of fQRS in addition to ST/T on ECG may be more valuable in pre-diagnosis of Non-STEMI.