The Association Between Fragmeted QRS and ICD Shocks in patients with Left Ventricular Systolic Heart Failure

Year 2013, , 7 - 11, 01.01.2013

Fırat Özcan Osman Turak Derya Tok Sedat Avcı İskender Kadife Ahmet İşleyen Muhammed Cebeci Fatma Nurcan Başar Kumral Çağlı Serkan Topaloğlu Dursun Aras Sinan Aydoğdu

https://doi.org/10.5505/abantmedj.2013.25733

Abstract

OBJECTIVE: The relationship between fragmented QRS fQRS and mortality, ventricular arrhythmias in patients left ventricular systolic dysfunction has been studied and the results have been conflicting. In our study, we aimed to find the association between implantable cardioverter defibrillator ICD shocks and fQRS in patients who had functional capacity below 3and was not on antiarrhyhtmic drugs.METHODS: We consecutively included 156 systolic heart failure patients who applied to our clinic for routine clinic follow up. All patients had been implanted ICD for more than 1 year. All ICDs were interrogated for arrhythmic episodes. Patients were divided into two groups according to presence of fQRS. RESULTS: Patients in fQRS group had more shock events p: 0.001 . After regression analyze carried out fQRS was found to be predictor of shock events both for univariable OR: 8.2 3.8-9.8 , p>0.001 and multivariable analyzes OR: 3.8 2.1-7.9 , p>0.001 . CONCLUSION: fQRS predicted shock events in patients who had functional capacity below 3 and were not on antiarrhythmic therapy. The tendency for arrhythmic events seems as an important finding for this group of patients for clinical approach.

Keywords

Fragmented QRS, ICD, shock, heart failure

Sistolik Sol Kalp Yetmezliği Olan Hastalarda Fragmante QRS ile ICD şokları arasındaki ilişki

Abstract

AMAÇ: Sol ventrikül sistolik disfonksiyonu olan hastalarda fragmente QRS’in fQRS mortalite ve ventriküler aritmi ile ilişkisine dair farklı bilgiler mevcuttur. Biz çalışmamızda fQRS’in fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan implante edilebilir şok cihazı ICD taşıyan hasta grubundaki yaşanmış şok olayları ile ilişkisini saptamak istedik. YÖNTEMLER: Çalışmamız 1 yılı aşkın süredir ICD implante edilmiş fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan rutin klinik kontrollere gelen 156 sistolik kalp yetmezliği hastasını kapsamaktadır. Tüm hastaların ICD kontrolleri daha önceden yaşamış oldukları artimik olaylar için yapılmıştır. Hastalar fQRS varlığına göre ikiye ayrılıp analizler yapılmıştır.BULGULAR: Fragmantasyon olan ve olmayan grup karşılaştırıldığı zaman fragmantasyon olan grupta anlamlı düzeyde şok olayı vardı p: 0.001 . Regresyon analizi yapıldığında fragmantsyon varlığının hem şoku predikte ettiği hem tek Odds oranı: 8.2 3.8-9.8 , p>0.001 hem de çok değişkenli analiz regresyon analizi ile saptanmıştır Odds oranı: 3.8 2.1-7.9 , p>0.001 . SONUÇ: Fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan hastalarda fQRS varlığı cihaza bağlı şok olaylarını predikte etmektedir. Bu bulgu fQRS’in bu grup hastalarda aritmik olaylara yatkınlığı göstermesi klinik yaklaşım açısından önemli gözükmektedir.

Keywords

fragmante QRS, ICD, şok, kalp yetmezliği

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