The Relationship Between Fragmentation QRS And The Prognosis With Patients With Idiopathic Dilated Cardiomyopathy

[Objective] To investigate the relationship between fragmentation of QRS and theprognosis with patients with idiopathic dilated cardiomyopathy.[Methods] Patients who are diagnosed as idiopathic dilated cardiomyopathy in ourhospital from January,2009to January,2011were analyzed respectiveiy.Twelve-lead ECGbased on the presence or absence of QRS fragmention, the study populations were dividedinto the fragmentation of the QRS groups and non-fragmentation QRS group;comparingtwo groups of patients followed up comparison of2groups of patients for all-causemortality and incidence of ventricular arrhythmias.[Results] A total of85patients were enrolled, including49males,36females, age23-87years, mean age63.5±13.1years old. QRS fragmentation group41(48.2%)patients,44non-fragmented QRS group (51.8%) cases. Primary or secondary preventionof sudden cardiac death row implantable cardioverter defibrillator implanted in six cases.Compared with non-fQRS group, fQRS in NYHA class III-IV level of heart function (P=0.023), QRS duration (P <0.001), sustained ventricular tachycardia or ventricularfibrillation (P=0.005) differences; ICD implants were in fQRS group, sustainedventricular tachycardia/ventricular fibrillation occurred in fQRS group; groups wereother indicators of age, sex, left ventricular ejection fraction, left ventricular end-diastolicby the relevant diseases, drug use and heart failure readmission, showed no statisticallysignificant differences between groups. Follow-up2-33(16.5±9.4) months,13(15.3%)patients had died and ventricular arrhythmias, of which8(9.4%) cases of all-causemortality,5(5.9%) patients with ventricular arrhythmias. Composite endpoint ofall-cause mortality and ventricular arrhythmias, fQRS group was significantly higher thannon-fQRS group (12/13vs1/13, P=0.001). fQRS group of five cases occurred inventricular arrhythmias, non fQRS was no ventricular arrhythmias, more significant difference between the two groups (P=0.023). However, heart failure readmission Therewas no statistical difference. During follow-up,10patients underwent cardiacresynchronization therapy. fQRS group of cardiac death occurred in7patients, accountingfor87.5%of mortality due to its central four cases of sudden cardiac death, cardiac deathaccounted for57.1%, accounting for50%fQRS groups. Non-fQRS group1patient diedof heart failure worse. Kaplan-Meier survival analysis QRS fragmentation group decreasedsurvival (P=0.044), multivariate Cox regression analysis revealed that the QRSfragmentation is idiopathic dilated cardiomyopathy all-cause mortality and ventriculararrhythmias strong predictor (odds ratio1.182, P=0.038).[Conclusion] QRS fragmentation associated with poor prognosis of idiopathic dilatedcardiomyopathy, the fragmentation QRS idiopathic dilated cardiomyopathy patients have ahigher predictive value for all-cause mortality and ventricular arrhythmias.