Relationship between fragmented QRS complexes in leads V4-V6 and left ventricular apical thrombus formation in patients presenting with first acute anterior myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2017; 45(3): 219-226 | DOI: 10.5543/tkda.2017.03753

Relationship between fragmented QRS complexes in leads V4-V6 and left ventricular apical thrombus formation in patients presenting with first acute anterior myocardial infarction

Erkan Baysal1, Cengiz Burak2, Barış Yaylak1, Bernas Altıntaş1, Önder Öztürk1, Hacı Çiftçi1, Rojhat Altındağ1, Serdar Söner1
1Department Of Cardiology, Diyarbakır Gazi Yaşargil Education And Research Hospital
2Midyat State Hospital


OBJECTIVE
The present study was an investigation of the relationship between fragmented QRS (fQRS) and left ventricular apical thrombus (LVAT) in patients presenting with first acute anterior myocardial infarction (MI).

METHODS
Consecutive 148 patients (mean age: 60.1±10.1 years; male: 75.6%) with first acute anterior MI who underwent primary percutaneous coronary intervention (PCI) were included. Study population was divided into 2 groups based on presence of LVAT. fQRS was defined as presence of various RSR’ patterns, which included additional R wave or notching of R wave or S wave, and presence of more than 1 R in 2 contiguous leads corresponding to major coronary artery territory on 12-lead electrocardiogram. Patients with bundle branch block were excluded from the study.

RESULTS
Of these, 32 (21.6%) had LVAT. Patients with LVAT had higher prevalence of fQRS (53.1% vs. 22.4%; p<0.001) and lower rate of successful PCI (75% vs. 94%; p=0.002) compared with patients without LVAT. More patients in LVAT group had left ventricular ejection fraction of <30% (87.5% vs 65.5%; p=0.010). Groups were similar with respect to other baseline characteristics (p>0.05 for all). Presence of fQRS was independent predictor of LVAT (odds ratio [OR], 2.795; 95% confidence interval [CI], 1.058–7.396) in multivariable logistic regression analysis.

CONCLUSION
Presence of fQRS in leads V4-V6 is independently associated with LVAT in patients presenting with first acute anterior MI.

Keywords: Fragmented QRS, left ventricular apical thrombus; myocardial infarction.

How to cite this article
Erkan Baysal, Cengiz Burak, Barış Yaylak, Bernas Altıntaş, Önder Öztürk, Hacı Çiftçi, Rojhat Altındağ, Serdar Söner. Relationship between fragmented QRS complexes in leads V4-V6 and left ventricular apical thrombus formation in patients presenting with first acute anterior myocardial infarction. Turk Kardiyol Dern Ars. 2017; 45(3): 219-226

Corresponding Author: Erkan Baysal, Türkiye
© Copyright 2019 Archives of the Turkish Society of Cardiology
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