Predictive value of fragmented QRS for ventricular tachyarrhythmias in patients with acute myocardial infarction: A meta-analysis.

Abstract

Recent studies indicated that fragmented QRS (fQRS) is associated with malignant cardiac arrhythmias in patients with acute myocardial infarction (AMI). However, a systematic review and meta-analysis on this issue still have not been conducted. Thus, we performed a systematic review and meta-analysis to access the predictive value of fQRS for ventricular tachyarrhythmias (VTAs) in patients with AMI. We searched the databases of PubMed, Embase and Cochrane Library for relevant studies until 8 June 2019. We included studies which compared VTAs in AMI patients with fQRS vs without fQRS. Six studies enrolling 2218 ST-segment elevation myocardial infarction (STEMI) patients were included in this meta-analysis. The fQRS was significantly associated with greater risk of VTAs in STEMI patients (Odds ratio [OR] 2.81, 95% confidence interval (CI) 1.99-3.95, P<.00001; I2 =30%). This association was still significant both in prospective (OR 3.25, 95% CI 1.94-5.46, P<.00001; I2 =0%) and retrospective (OR 2.40, 95% CI 1.22-4.74, P=.01; I2 =54%) studies. In particularly, fQRS in patients with low left ventricular ejection fraction (≤50%) (OR 2.97, 95% CI 1.88-4.70, P<.00001; I2 =21%) or <60years old (OR 3.07, 95% CI 2.02-4.66, P<.00001; I2 =0%) tripled the risk of VTAs during AMI. Our meta-analysis demonstrated that fQRS increases the risk of developing VTAs in patients with STEMI.