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Title: Baseline fragmented QRS increases the risk of major arrhythmic events in hypertrophic cardiomyopathy: Systematic review and meta-analysis
Authors: Pattara Rattanawong
Tanawan Riangwiwat
Chanavuth Kanitsoraphan
Pakawat Chongsathidkiet
Napatt Kanjanahattakij
Wasawat Vutthikraivit
Eugene H. Chung
Duke University Medical Center
University of Michigan Medical School
Texas Tech University Health Sciences Center at Lubbock
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
University of Hawaii at Manoa
Faculty of Medicine, Siriraj Hospital, Mahidol University
Einstein Medical Center
Keywords: Medicine
Issue Date: 1-Jul-2018
Citation: Annals of Noninvasive Electrocardiology. Vol.23, No.4 (2018)
Abstract: © 2018 Wiley Periodicals, Inc. Background: Fragmented QRS reflects disturbances in the myocardium predisposing the heart to ventricular tachyarrhythmias. Recent studies suggest that fragmented QRS (fQRS) is associated with worse major arrhythmic events in hypertrophic cardiomyopathy (HCM). However, a systematic review and meta-analysis of the literature has not been done. We assessed the association between fQRS and major arrhythmic events in hypertrophic cardiomyopathy by a systematic review of the literature and a meta-analysis. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to May 2017. Included studies were published prospective or retrospective cohort studies that compared major arrhythmic events (sustained ventricular tachycardia, sudden cardiac arrest, or sudden cardiac death) in HCM with fQRS versus non-fQRS. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate risk ratios and 95% confidence intervals. Results: Five studies from January 2013 to May 2017 were included in this meta-analysis involving 673 subjects with HCM (205 fQRS and 468 non-fQRS). Fragmented QRS was associated with major arrhythmic events (pooled risk ratio = 7.29, 95% confidence interval: 4.00–13.29, p <.01, I 2  = 0%). Conclusion: Baseline fQRS increased major arrhythmic events up to sevenfold. Our study suggests that fQRS could be an important tool for risk assessment in patients with HCM.
ISSN: 1542474X
Appears in Collections:Scopus 2018

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