Clinical Research The Prognostic Significance of Fragmented QRS in Patients With Left Ventricular Noncompaction Cardiomyopathy

Background: Fragmented QRS complexes (fQRS) were proven to be associated with the prognosis of several heart diseases. However, no data is available regarding fQRS in left ventricular noncompaction cardiomyopathy (LVNC), in which the outcome varies greatly and a simple yet practicable prognostic predictor is needed. The purpose of this study was to determine the prognostic value of fQRS in LVNC patients. Methods: Sixty-four LVNC patients were evaluated. Fragmented narrow QRS (f-nQRS) included single or multiple notches in the R or S wave in at least 2 contiguous electrocardiogram (ECG) leads and QRS duration 120 ms, fragmented wide QRS (f-wQRS) included more than 2 notches and QRS duration 120 ms. Results: f-nQRS and f-wQRS was present in 24 (38%) and 7 (11%) patients respectively. During follow-up, 13 patients died and 7 patients underwent heart transplantation. Kaplan-Meier analysis revealed that compared with the non‐f-nQRS group, the f-nQRS group associated with a significantly lower survival (P 0.005). The f-wQRS group also demonstrated a substantially lower survival as compared with the non‐f-wQRS group (P 0.02). Multivariate analysis indicated fnQRS was an independent predictor of all-cause mortality (HR: 5.33; P 0.045). Conclusions: In LVNC patients, the presence of f-nQRS has significant prognostic value and may provide a valid method of risk stratification.