目的评价碎裂QRS波(fQRs波)在致心律失常性右心室心肌病(ARVC)诊断中的价值。方法43例符合ARVC诊断标准的患者,男性33例,平均年龄(40.4±13.9)岁。采集临床资料,记录静息状态下标准12导联心电图,描述fQRs波的心电图特征,判断是否存在fQRs波、epsilon波和右胸前导联T波倒置(TWI)并比较其阳性率之间的差异。结果本组患者fQRs波以下壁导联(44.3%)和右胸前导联(24.2%)最为多见。QRS波中,fQRs波见于R波者多于S波者(58.4%对32.9%,Z=4.30,P〈0.01)。共31例患者判断为fQRS波阳性,2~9(4.6±1.7)个/例。fQRs波阳性率较epsilon波(73.8%VS30.2%,Z=3.67,P〈0.01)和TWI(73.8%对41.9%,Z=2.61,P〈0.01)显著增高。结论fQRs波阳性是ARVC患者常见的心电图异常,常见于下壁和右胸前导联,可作为提示诊断的无创心电指标。
Objective To evaluate diagnostic value of fragmented QRS complex (fQRS)in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods Forty-three patients [ 33 men, aged (40.4 ± 13.9)years] meet the ISFC/ESC diagnostic criteria for ARVC were enrolled in this study. A standard twelve-lead electrocardiogram was obtained during the resting status. Characteristics of fQRS were detailedly studied by three doctors independently. A comparison of the prevalence among fQRS, epsilon wave and T wave inversion (TWI)in the right precordial leads exceeding V3 was done. Results Most fQRS could be found in the inferior leads (44. 3% )and the fight precordial leads (24. 2% ). Within the QRS complex, the prevalence of fQRS in the R wave was significantly higher than it in the S wave(58.4% vs 32. 9% ,Z =4. 30,P 〈0. 01 ). fQRS could be found in a total of 31 of 43 cases (mean 4. 6 ± 1.7 (range 2 to 9 )per patient). The prevalence of fQRS was significantly higher than that of epsilon wave ( 73.8% vs 30. 2%, Z = 3.67, P 〈 0. 01 ) and TWI (73.8% vs 41.9% ,Z =2. 61 ,P 〈0. 01 ). Conclusion fQRS was a common electrocardiographic abnormality, and most was found in the inferior and right precardial leads in patients with ARVC. It may be used as an im- portant noninvasive preliminary screening electrocardiographic criteria.