The prognostic value of fragmented QRS in patients undergoing transcatheter aortic valve implantation

J Electrocardiol. 2018 Nov-Dec;51(6):923-927. doi: 10.1016/j.jelectrocard.2018.07.015. Epub 2018 Jul 18.

Abstract

Background: Although transcatheter aortic valve implantation (TAVI) can successfully correct aortic narrowing, pre-existing pathophysiological alterations in the left ventricle are still a concern in terms of long-term mortality. This study aimed to examine the predictive role of fQRS morphology on long-term prognosis in patients undergoing TAVI due to severe aortic stenosis.

Methods: A total of 117 patients undergoing TAVI due to severe aortic stenosis were included in this retrospective cohort study. Patients were assigned into two groups based on the presence (n = 36) or absence (n = 81) of fQRS. Predictors of long-term survival were estimated.

Results: In-hospital mortality was higher in fQRS group (5.5% vs. 1.2%, p = 0.0224). In the long-term, fQRS (OR: 3.06, 95% CI 1.29-7.27, p: 0.01), LVEF <50% (OR: 2.54, 95% CI 1.07-6.02, p: 0.03) and presence of atrial fibrillation (OR: 2.42, 95% CI 1.05-5.60, p: 0.03) emerged as significant independent predictors of short survival.

Conclusion: Presence of fQRS on ECG, an indirect indicator of myocardial fibrosis, seems to have the potential to be used as a prognostic marker after TAVI procedure. Large prospective studies are warranted.

Keywords: Aortic stenosis; Fragmented QRS (fQRS); Myocardial fibrosis; Prognosis; Transcatheter aortic valve implantation (TAVI).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve Stenosis / mortality
  • Aortic Valve Stenosis / surgery*
  • Atrial Fibrillation / mortality
  • Atrial Fibrillation / physiopathology
  • Comorbidity
  • Echocardiography
  • Electrocardiography
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Transcatheter Aortic Valve Replacement*
  • Ventricular Dysfunction, Left / mortality
  • Ventricular Dysfunction, Left / physiopathology*