[Magnetcardiographic detection of abnormal intraventricular activation in patients with ischemic heart disease with and without tachycardia]

Fragmented QRS complex: a novel marker of cardiovascular disease

QRS complex fragmentation, defined as changes in QRS morphology with different RSR' patterns: additional R waves, notched S wave, or > 1R' wave, has recently been linked with various cardiac conditions and even been postulated to be predictive of outcomes in certain pathologies. The current article aims to consolidate the available information about this morphological ECG abnormality and its predictive value.

Magnetocardiographic analysis of the two-dimensional distribution of intra-QRS fractionated activation

The spatial distribution of high-frequency components in magnetic signals during the QRS complex of the human heartbeat was investigated. Cardiomagnetic signals were recorded simultaneously using 49 first-order magnetogradiometer channels of a multi-SQUID system with a low noise power density. The QRS fragmentation score S, as a measure of the fragmentation of the bandpass-filtered QRS complex, was examined for its sensitivity and specificity to discriminate 34 healthy volunteers, 42 post-myocardial infarction patients and 43 patients with coronary heart disease and with a history of malignant sustained ventricular tachycardia or ventricular fibrillation. The multichannel information was visualized by two-dimensional mapping of the score values of the single channels. By averaging the score values for the seven central channels, S7, the score values of all 49 channels, S49, and calculating the standard deviation for all 49 channels, D49, a higher sensitivity and specificity for detecting patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) was reached than by analysis of a single channel. Combination of these parameters furnishes a sensitivity of 90% and a specificity of 70% for identifying patients prone to VT/VF. The results were compared with diagnostic information obtained from the QRS duration of the signal as well as with results obtained by modified QRS integral mapping.