Incidence And Significance Of Fragmented QRS In Elderly Patients With Acute Myocardial Infarction

Objective: To research the incidence of fragmented QRS(f QRS) complexes in patients of acute myocardial infarction in elderly population(≥ 65 years), and to research the relationship between f QRS and cardiac events.Methods: 1、Collect clinical data of elderly patients(≥65) with acute myocardial infarction according to the criteria for the collection between January 2009 and December 2009 in our hospital, including clinical manifestation, electrocardiogram, cardiac markers, such as myocardial enzyme examination, imaging, coronary angiography examination, complications and smoking status. Remove medical record exclusion criteria; 2、Standard electrocardiogram within 72 h hospitalization of 192 patients of acute myocardial infraction in elderly people were assessed and analyzed for the presence of f QRS. Patients were divided into two groups based on the presence of f QRS; 3、Analyzing FQRS and the control group, Study the incidence of f QRS in elderly patients with acute myocardial infarction; Study the correlation of FQRS and coronary artery disease in coronary angiography results; 4、Following-up 1-3 years for selected patients with, observe the happence of cardiac event.Cardiac events includ the recurrence of myocardial infarction, height or Ⅲ degree atrioventricular block, ventricular tachycardia/ventricular fibrillation, cardiac death. Investigate the relationship between f QRS and cardiac events According to analysising f QRS group and the control group.Results: 1、f QRS was detected in a total of 116 patients( 60.41%) out of 192 cases and the incidence of f QRS in the inferior leads, anterior leads, lateral leads, right ventricular leads and the posterior leads was 87.93%(n=102), 48.28%(n=56), 25.86%(n=30), 18.1%(n=21)and 6.9%(n=8)respectively. The frequency of f QRS in the inferior leads was significantly higher than that in the other leads; 2、Coronary lesions was found in 73 patients out of the 74 cases performed coronary angiography(CAG) in the study, the results showed that the incidence of multi-vessels(3 or more) disease were significantly higher in f QRS group. 3、During the period of following up, the incidence of re-infraction, high degree or absolutely atrio-ventricular block, ventricular tachycardia/ventricular fibrillation malignant arrhythmia events was significantly higher in the patients presenting f QRS(P<0.05).Conclusions: 1 、 The incidence of f QRS in the inferior wall is significantly higher than that in the other walls. 2 、 The incidence of f QRS as well as the cardiac events are significantly higher when multi-vessels(3 or more) are affected. 3、The total frequency of cardiac events in f QRS group increase significantly and also have the worse clinic ending.