Fragmented QRS is associated with frequency of premature ventricular contractions in patients without overt cardiac disease

Anatol J Cardiol. 2015 Jun;15(6):456-62. doi: 10.5152/akd.2014.5467. Epub 2014 Apr 8.

Abstract

Objective: In this study, we aimed to demonstrate whether the presence of fragmented QRS (fQRS) is associated with the frequency of premature ventricular contractions (PVCs).

Methods: We retrospectively analyzed 282 cases by 24-hour Holter monitorings (HMs) between August 2012 and February 2013. Firstly, the patients were divided into 2 groups with respect to presence of fQRS and then divided into 3 groups with respect to frequency of PVCs as Group 1: seldom PVC (<120 PVCs/day), Group 2: moderate-frequency PVC (120-720 PVCs/day), and Group 3: frequent PVC (>720 PVCs/day). We investigated the predictors of frequent PVCs by using multinomial logistic regression analysis.

Results: Ninety-eight patients had fQRS. There was no difference between the 2 groups with respect to body mass index, gender, hypertension, and diabetes mellitus. Patients with fQRS were older (54.9±15.6 vs. 47.0±16.3, p<0.001) and had more family history of coronary artery disease (25% vs. 13%, p=0.012). Patients with fQRS was more likely to be on aspirin therapy (28.6% vs. 10.4%, p<0.001) and have a larger left atrium diameter (33.5±5.7 vs. 30.4±5.8, p=0.001). Presence of fQRS was significantly associated with the frequency of PVCs (for frequent PVC 27.7% vs. 7.6%, p<0.001; for moderate-frequency PVC 18.4% vs. 11.4%, p=0.012); 26.2% of Group 1 (n=202) had fQRS, 46.2% of Group 2 (n=39) had fQRS, and 65.9% of Group 3 (n=41) had fQRS. In the multinomial regression analysis, only age (odds ratio: 4.24, 95% confidence interval 2.08-8.64, p=0.001) and fQRS (odds ratio: 2.11, 95% confidence interval 1.00-4.45, p=0.05) were predictors of frequent PVCs.

Conclusion: This study demonstrated that the presence of fQRS is associated with frequent PVCs in patients without overt structural heart disease.

MeSH terms

  • Adult
  • Coronary Artery Disease / physiopathology*
  • Electrocardiography
  • Electrocardiography, Ambulatory
  • Female
  • Heart Conduction System
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Premature Complexes / physiopathology*