Prognostic significance of fragmented QRS in acute pulmonary embolism

Karaca M., Tatlisu M. A., Ozcan K. S., Gungor B., Bozbeyoglu E., Yildirimturk O., ...More

Acta Cardiologica, vol.71, no.4, pp.443-448, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 71 Issue: 4
  • Publication Date: 2016
  • Doi Number: 10.2143/ac.71.4.3159697
  • Journal Name: Acta Cardiologica
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.443-448
  • Keywords: Acute pulmonary embolism, QRS fragmentation, mortality
  • Istanbul Medipol University Affiliated: Yes


Background Presence of fragmented QRS (fQRS) complex in a 12-lead electrocardiogram (ECG) has been shown to represent alternation of myocardial activation owing to myocardial scar. The aim of this study was to investigate whether presence of fQRS complex predicts in-hospital and long-term mortality in patients with acute pulmonary embolism (APE). Methods This study included 186 consecutive patients with APE. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. ECG was obtained immediately after admission. Results Patients were divided into two groups: patients who had fQRS on their ECG (n = 52), and patients who did not have fQRS on their ECG (n = 134). The fQRS was associated with not only in-hospital mortality (P = 0.02) but also long-term mortality (P = 0.01). Furthermore, the fQRS was found to be a significant predictor of in-hospital and long-term mortality in multivariable Cox analyses. Conclusion In this study, fQRS was found to be predictors of both in-hospital and long-term mortality. Electrocardiography can be used to detect high-risk patients in APE; moreover, it bears little risk, is inexpensive, and easy to perform.