Investigation of short-term prognosis of fragmented QRS complexes in patients with acute myocardial infarction in two groups that received invasive and fibrinolytic therapy

Abstract

Background: Studies have shown that the primary causes of death in patients with acute coronary syndrome are arrhythmias and heart failure. The aim of this study is to evaluate the short-term prognosis of fragmented QRS (f-QRS) in patients with acute myocardial infarction (MI).

Methods: This study was a prospective and longitudinal analytic study performed on all patients with acute MI admitted to Rasht Heshmat Hospital Emergency during 2018-2019. Serial Electrocardiography (ECG) was performed in the emergency room after patient admission and was repeated 24 h after percutaneous coronary intervention and fibrinolytic therapy, as well as at the time of patient discharge. Short-term prognosis of f-QRS in patients was evaluated by a cardiologist within admission, 40 days after hospitalization and three months later again.

Results: In this study, 453 patients with MI were evaluated in two treatment methods of fibrinolytic and invasive with and without f-QRS. Based on the data of this study, the four study groups had no statistically significant difference in arrhythmia (p = 0.196). In addition, the effect of study groups on left ventricular ejection fraction index was not statistically significant (p = 0.597). The probability of adverse outcomes occurrence was not statistically significant among the four groups (p = 0.07).

Conclusion: The final results of this study showed that there was no significant difference between the four study groups and arrhythmia status. Therefore, f-QRS was not introduced as an independent predictor of arrhythmia in patients with acute MI.

Keywords: Acute coronary syndrome; Fragmented QRS complexes; Non-ST elevated acute myocardial infarction; Prognosis.