碎裂QRS波预测ARVC患者室性心律失常事件

薛社亮; 徐波; 李文华; 蔡高军; 宋艳斌; 俞磊; 李峰; 肖建强

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碎裂QRS波预测ARVC患者室性心律失常事件

临床研究 | 更新时间：2025-10-15

- 碎裂QRS波预测ARVC患者室性心律失常事件
- Fragmented QRS as a predictor of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy
- 临床心电学杂志 2022年第3期页码：168-171
- 作者机构：
  
  1. 江苏大学附属武进医院心血管内科
  2. 徐州医科大学武进临床学院心血管内科
- 作者简介：
- 基金信息：
- DOI：
  中图分类号： R541.7
- 纸质出版：2022
- 稿件说明：
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薛社亮, 徐波, 李文华, 等. 碎裂QRS波预测ARVC患者室性心律失常事件[J]. 临床心电学杂志, 2022,(3):168-171.

Xue sheliang, Xu bo, Li wenhua, et al. Fragmented QRS as a predictor of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy[J]. 2022, (3): 168-171.
薛社亮, 徐波, 李文华, 等. 碎裂QRS波预测ARVC患者室性心律失常事件[J]. 临床心电学杂志, 2022,(3):168-171. DOI：

Xue sheliang, Xu bo, Li wenhua, et al. Fragmented QRS as a predictor of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy[J]. 2022, (3): 168-171. DOI：

摘要

目的探讨心电图碎裂QRS波（Fragmented QRS Complex

f QRS）对致心律失常性右室心肌病（Arrhythmogenic Right Ventricular Cardiomyopathy

ARVC）患者室性心律失常事件发生的远期预测价值。方法 2007年1月至2008年11月顺序入组35例ARVC患者（男性28例，年龄38.6±11.0岁），分析并记录其临床资料，如晕厥史、家族史、服药史、心电图f QRS、左室射血分数（LVEF）、心功能分级等，并随访观察阳性事件发生情况。随访方案为每3-6月进行一次电话或门诊随访，有症状随时就诊。阳性事件定义为症状性持续性室性心动过速、ICD恰当治疗及心脏性猝死的发作情况。结果致心律失常性右室心肌病患者35例，随访99.9±7.7个月，15例发生阳性事件（其中1例为心脏性猝死，其余14例发生持续性室速，2例因室速发生晕厥，2例植入ICD者因室速行放电治疗）。生存分析-单因素Cox回归模型提示，f QRS(HR3.0;95%CI:0.95-9.46;p=0.05)是随访中阳性事件发生的高危因素；Kaplan-Meier曲线分析表明，f QRS波阳性患者无心律失常事件的累积生存率显著降低。结论碎裂QRS波是ARVC患者室性心律失常事件发生的高危因素。

Abstract

Objective To investigate the long-term prediction value of fragmented QRS（f QRS） for ventricular arrhythmia events in patients with arrhythmogenic right ventricular cardiomyopathy（ARVC）. Methods Thirty-five ARVC patients were enrolled from January 2007 to November 2008. Clinical data were analyzed and recorded

such as syncope history

family history

medication history

f QRS

left ventricular ejection fraction（LVEF）

and cardiac function classification. A positive event was defined as the first occurrence of sudden cardiac death（SCD）

documented sustained ventricular tachycardia（VT）

ventricular fibrillation（VF）

or the administration of appropriate implantable cardioverter defibrillator（ICD） therapy. Results The 35 ARVC patients were followed up for 99.9±7.7months and 15 positive events occurred. The univariate Cox regression model for survival showed that f QRS was a high risk factor for positive events during follow-up. Kaplan-Meier curve analysis showed a significant decrease in cumulative survival without arrhythmia events in patients with f QRS. Conclusions Fragmented QRS could predict ventricular arrhythmia events in ARVC patients.

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references

碎裂QRS波在致心律失常性右心室心肌病诊断中的价值[J]. 周秀娟;杨兵;王静;陈明龙;张凤祥;居维竹;陈红武;王本琪;丰尚鹏;丁祥伟;曹克将.中华心律失常学杂志,2011(01)

Clinical Diagnosis, Imaging, and Genetics of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia[J]. Estelle Gandjbakhch;Alban Redheuil;Fran?oise Pousset;Philippe Charron;Robert Frank.Journal of the American College of Cardiology,2018(7)

Fragmented QRS complex predicts the arrhythmic events in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.[J]. Canpolat U?ur;Kabak?i Giray;Aytemir Kudret;Dural Muhammet;Sahiner Levent;Yorgun Hikmet;Sunman Hamza;Bari? Kaya Ergün;Tokg?zo?lu Lale;Oto Ali.Journal of cardiovascular electrophysiology,2013(11)

Fragmented QRS on twelve-lead electrocardiogram predicts arrhythmic events in patients with ischemic and nonischemic cardiomyopathy[J]. Mithilesh Kumar Das;Waddah Maskoun;Changyu Shen;Mark A. Michael;Hussam Suradi;Mona Desai;Roopa Subbarao;Deepak Bhakta.Heart Rhythm,2009(1)

Fragmented QRS on a 12-lead ECG: A predictor of mortality and cardiac events in patients with coronary artery disease[J]. Mithilesh Kumar Das;Chandan Saha;Hicham El Masry;Jonathan Peng;Gopi Dandamudi;Jo Mahenthiran;Paul McHenry;Douglas P. Zipes.Heart Rhythm,2007(11)

Significance of a fragmented QRS complex versus a Q wave in patients with coronary artery disease.[J]. Das Mithilesh K;Khan Bilal;Jacob Sony;Kumar Awaneesh;Mahenthiran Jo.Circulation,2006(21)

Diagnosis of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Task Force of the Working Group Myocardial and Pericardial Disease of the European Society of Cardiology and of the Scientific Council on Cardiomyop[J]. McKenna W J;Thiene G;Nava A;Fontaliran F;BlomstromLundqvist C;Fontaine G;Camerini F.British Heart Journal,1994(3)

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