Presence of Fragmented QRS may be Associated with Ventricular Arrhythmias in Hemodialysis Patients

Year 2022, Volume: 3 Issue: 2, 92 - 100, 01.08.2022

Fatih Kardaş , Gökay Taylan , Çağlar Kaya , İlhan Kurultak

Abstract

Introduction: Fragmented QRS (fQRS) is a depolarization defect that can be seen in a 12-derivation electrocardiography (ECG). It has been determined that myocardial fibrotic scar plays a role in the formation of ventricular arrhythmias by causing structural and electrophysiological changes that cause fragmentation and ventricular late potentials in QRS. Arrhythmia risk is increased in hemodialysis (HD) patients. Regular ECG monitoring and the presence of fQRS can help in the early diagnosis of ventricular arrhythmias in HD patients. The aim of this study is to investigate the relationship between the presence of fQRS and ventricular arrhythmia in HD patients. Methods: In this case-control study, 22 HD patients with fQRS and 72 HD patients without fQRS were compared. The ECG parameters and ECG-holter results of the two groups were compared in terms of the frequency of ventricular arrhythmias by multivariate analysis. A p value <0.05 was considered statistically significant. Results: The compared to ECG-holter data of the both groups, it was statistically detected that the frequency of ventricular premature contraction (VPC) and the number of cases observed in non-susteined ventricular tachycardia (NSVT) increased in the group with fQRS (+) (p <0.001, p:0.01). In addition, it was observed that corrected QT (QTc), dispersion of QTc (QTcd) and transmural dispersion of repolarization (TDR) were extended from ECG parameters in the fQRS (+) group and were statistically significant (p <0.001, p:0.003, p:0.019). Conclusion: The frequency of VPC and NSVT in the fQRS group was significantly higher than in the control group. The presence of fQRS may be used to predict ventricular arrhythmias in HD patients.

Keywords

Electrocardiography, fragmented QRS, hemodialysis, ventricular arrhythmias

Fragmente QRS'nin Varlığı Hemodiyaliz Hastalarında Ventriküler Aritmi ile İlişkili Olabilir

Abstract

Giriş: Fragmente QRS (fQRS), 12-derivasyon elektrokardiyografide (EKG) görülebilen bir depolarizasyon kusurudur. Miyokardiyal fibrotik skarın, QRS'de parçalanma ve ventriküler geç potansiyellere neden olarak yapısal ve elektrofizyolojik değişiklik sonucu ventriküler aritmilerin oluşumunda rol oynadığı belirlenmiştir. Hemodiyaliz (HD) hastalarında aritmi riski artmıştır. Düzenli EKG izleme ve fQRS' lerin varlığı HD hastalarında ventriküler aritmilerlerin erken teşhisinde yardımcı olabilir. Bu çalışmanın amacı HD hastalarında fQRS' lerin varlığı ile ventriküler aritmi arasındaki ilişkiyi araştırmaktır. Yöntemler: Bu vaka-kontrol çalışmasında, fQRS saptanan 22 HD hastası ile fQRS saptanmamış 72 HD hastası karşılaştırıldı. İki grubun EKG parametreleri ve EKG-Holter sonuçları, çok değişkenli analiz yoluyla ventriküler aritmiler sıklığı açısından karşılaştırıldı. P değeri <0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Her iki grubun EKG-Holter verileri kıyaslandığında, ventriküler erken vuru (VEV) sıklığının ve süreksiz ventriküler taşikardi (NSVT) gözlenen olguların sayısının fQRS (+) grupta arttığı istatistiksel anlamlı görüldü (p <0,001, p: 0,01). Ek olarak, EKG parametrelerinden düzeltilmiş QT intervali (QTc), QTc dispersionu (QTcd) ve repolarizasyonun transmural dispersiyonu (TDR)’ nun fQRS (+) grubunda uzadığı ve istatistiksel olarak anlamlı olduğu saptandı (p <0,001, p: 0,003, p: 0,019). Sonuç: FQRS grubundaki VEV ve NSVT sıklığı, kontrol grubundan anlamlı olarak yüksekti. FQRS' lerin varlığı hemodiyaliz hastalarında ventriküler aritmileri tahmin etmek için kullanılabilir.

Keywords

Elektrokardiyografi, fragmente QRS, hemodiyaliz, ventriküler aritmi

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