Fragmented QRS; as a new sign on ecg for pre-diagnosis of non-ST elevation myocardial infarction

Aim: The aim of this study is to evaluate the predictive value of fragmented QRS (fQRS) wave to detect non-ST elevation myocardial infarction (Non-STEMI). Material and Methods: The study included patients who were diagnosed with Non-STEMI in emergency department and underwent percutaneous coronary intervention in the cardiology clinic. Coronary artery circulation is anatomically divided as the left anterior descending coronary artery (LAD) (V1-V5), the left Circumflex (LCx) (I, aVL and V5,V6) and the right coronary artery (RCA) (II, III and aVF). Results: Our study included 191 patients. Significant fQRS was detected in 139 (%73) patients and ST/T was detected in 79 (%41) patients. The sensitivity, specificity, of fQRS in the inferior leads to predictRCAlesion was 76%, 46%, respectively. The sensitivity, specificity, of ST/T in the inferior leads to predictRCA lesion was 12%, 93%, respectively. The sensitivity, specificity of fQRSin the lateral leads to predictLCx lesion were 44%and 83%, respectively. The sensitivity, specificity of ST/T in the lateral leads to predictLCxlesion were 34%, 74%, respectively. The sensitivity, specificity of fQRSin the anterior leads to predict leftLAD lesion were 34% and 82%, respectively. The sensitivity, specificity of ST/T in the anterior leads to predictLAD lesion were 38%, and 81%, respectively. Conclusion: We have compared to fQRS and ST/T on ECG; fQRS has higher sensitivity than ST/T to predict culprit coronary artery lesion. Therefore, evaluation of fQRS in addition to ST/T on ECG may be more valuable in pre-diagnosis of Non-STEMI.