Naveenkumar, N (2023) A Study on Fragmented QRS as a Predictor of LV Dysfunction in Nonstelevation Myocardial Infarction. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Acute coronary syndrome is now increasing and emerging as a major health problem. Owing to changing lifestyle, increasing prevalence of diabetes, hypertension adverse social habits like alcohol and smoking incidence of MI has increased. Novel therapies have reduced the mortality of MI drastically. Despite new therapies, poor outcome may still occur because Acute Coronary Syndrome is a heterogeneous disease in which outcome is influenced by many causative factors. The extent of myocardial injury and the resultant outcome from ischemia is largely dependent upon the physiological level by the severity and duration of the ischemia. Notching of QRS is poorly understood and underestimated. Various studies have shown the relation of fragmented QRS and ejection fraction. In this study we compare the NON STEACS with fragmented QRS and those without and its correlation with ejection fraction. BACKGROUND: Fragmented QRS in ECG is indicative of myocardial necrosis or scarring. OBJECTIVES: 1. To assess the usefulness of ECG as predictor of LV systolic dysfunction. 2. To compare the patients who don’t have that ECG finding in NSTEACS and estimate it’s usefulness. MATERIALS AND METHODS: Patients with NON ST ELEVATION Myocardial infarction admitted in the intensive coronary care unit are included in the study. The data of each patient is collected in a specifically prepared proforma and includes relevant medical history, ECG findings on admission and serial ECGs, and Ejection fraction assessed by Echocardiogram within 48 hours of onset of symptoms. Patients with fQRS in the ECG were taken as cases and patients without fQRS and Echo is done to assess the Ejection fraction. Using statistical methods ejection fraction between the two groups was analyzed. RESULTS: Analysis revealed mean ejection fraction of the cases group is 44.4% and the ejection fraction among the control group is 53.2% This study revealed that there is a statistically significant correlation between fragmented QRS and ejection fraction. CONCLUSION: It is possible to predict left ventricular dysfunction using fQRS. The outcome and mortality of patients with acute myocardial infarction can be predicted using fQRS. LIMITATIONS OF THE STUDY: ❖ A 12 lead ECG with a fragmented QRS requires a low pass filter setting of 100 or 150 Hz. With a filter setting of 40 or 60 Hz, fragmentation can be readily ignored. ❖ Its that a fragmented QRS is not a particular finding and should only be interpreted if there is sufficient clinical proof of myocardial scarring, such as in coronary artery disease or primary electrical anomalies like Brugada syndrome.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120100519 |
| Uncontrolled Keywords: | Fragmented QRS, Predictor, LV Dysfunction, Nonstelevation Myocardial Infarction. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Thavamani K |
| Date Deposited: | 24 May 2022 00:40 |
| Last Modified: | 17 Mar 2024 12:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/20112 |
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