Comparison Between Fragmented Qrs Complexes And Q-Waves In Detecting Myocardial Scar Using Myocardial Perfusion Imaging
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Date
2019
Authors
Dr Rosleena Sedi
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Introduction: The 12-lead electrocardiogram (ECG) is reliable and easily assessable
diagnostic tool to make accurate diagnosis of myocardial infarction (MI). Other than Qwaves,
fragmented QRS (fQRS) complexes on ECG has been used as a marker to indicate
prior MI nowadays.
Objective: To compare between fQRS complexes and Q-waves in detecting myocardial
scar by using myocardial perfusion imaging.
Methods: This prospective study included 246 patients for evaluation of coronary artery
disease (CAD) who undergone one-day myocardial perfusion imaging using
pharmacological study. 12-lead ECG was obtained to detect fQRS complexes and Qwaves.
Finally, myocardial perfusion imaging (MPI) performed to assess for perfusion
defect.
Results: A total number of 246 patients with mean age of 58.8 (±9.95) were analyzed.
There were 93 (37.8%) and 50 (20.3%) patients with fQRS complexes and Q-waves
respectively. MPI showed a total of 112 (45.5%) patients had myocardial scar. The
sensitivity, specificity, positive predictive value (PPV) and negative predictive value
(NPV) were 58.9%, 79.9%, 71.0% and 69.9%; 19.6%, 76.1%, 36.0% and 52.0% for fQRS
complexes and Q-waves respectively.
Conclusion: fQRS complexes showed higher sensitivity in detecting myocardial scar
when compared to Q-waves. Though, the specificity between fQRS complexes were
comparable to Q-waves but the PPV and NPV of fQRS complexes were higher when
compared with Q-waves in detecting myocardial scar.
Description
Keywords
Electrocardiography