Predicting arrhythmias in primary prevention heart failure patients: picking up the fragments

Engstrom, Nathan, Letson, Hayley Louise, Ng, Kevin, and Dobson, Geoffrey Phillip (2022) Predicting arrhythmias in primary prevention heart failure patients: picking up the fragments. Open Heart, 9 (2). e002075.

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Abstract

Identifying patients with high-risk heart failure (HF) who would benefit from an implantable cardioverter-defibrillator (ICD) remains controversial. A potential marker for arrhythmic sudden death is fragmented QRS (fQRS). fQRS is the notching and slurring of the QRS complex in a 12-lead ECG and it indicates abnormal ventricular depolarisation and myocardial scarring and fibrosis. However, before fQRS complex can be included into selection criteria for ICD therapy, more complete reporting is required on their association with malignant arrhythmias, left ventricular remodelling and myocardial scarring/fibrosis in patients with HF. The molecular basis of the fQRS-arrhythmia-fibrosis connection in HF also needs to be explored. It is not widely appreciated that changes in the QRS complex and phases 0 and 1 of the ventricular action potential occur before contraction and predetermine Ca2+ release during contraction and later Ca2+ sparks. It is currently not known whether the different zig-zag patterns of the QRS are associated with aberrant Ca2+ cycling and arrhythmogenic sparks in patients with HF.

Item ID: 75921
Item Type: Article (Research - C1)
ISSN: 2053-3624
Keywords: heart failure; implantable cardioverter-defibrillator; arrhythmia; ventricular fibrillation; ventricular tachycardia; ECG; fragmented QRS
Copyright Information: © Author(s) (or their employer(s)) 2022. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Date Deposited: 06 Sep 2022 00:16
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320101 Cardiology (incl. cardiovascular diseases) @ 100%
SEO Codes: 20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 70%
20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 30%
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