Predictive Value of Fragmented QRS for Ventricular Tachyarrhythmias in Patients with Acute Myocardial Infarction: A Meta-Analysis

BACKGROUND:

Recent studies indicated that fragmented QRS (fQRS) is associated with malignant cardiac arrhythmias in patients with acute myocardial infarction (AMI). However, a systematic review and meta-analysis on this issue still has not been conducted. Thus, we performed a systematic review and meta-analysis to access the predictive value of fQRS for ventricular tachyarrhythmias (VTAs) in patients with AMI.

MATERIALS AND METHODS:

We searched the databases of PubMed, Embase and Cochrane Library for relevant studies until Jun 08, 2019. We included studies which compared VTAs in AMI patients with fQRS versus without fQRS.

RESULTS:

Six studies enrolling 2,218 ST-segment elevation myocardial infarction (STEMI) patients were included in this meta-analysis. The fQRS was significantly associated with greater risk of VTAs in STEMI patients (Odd ratio (OR) 2.81, 95% confidence interval (CI) 1.99-3.95, p< 0.00001; I2= 30%). This association was still significant both in prospective (OR 3.25, 95% CI 1.94-5.46, p< 0.00001; I2= 0%) and retrospective (OR 2.40, 95% CI 1.22-4.74, p=0.01; I2= 54%) studies. In particularly, fQRS in patients with low left ventricular ejection fraction (≤50%) (OR 2.97, 95% CI 1.88-4.70, p< 0.00001; I2= 21%) or <60 years old (OR 3.07, 95% CI 2.02-4.66, p< 0.00001; I2= 0%) tripled the risk of VTAs during AMI.

CONCLUSION:

Our meta-analysis demonstrated that fQRS increases the risk of developing VTAs in patients with STEMI.