Presence of fragmented QRS may be associated with complex ventricular arrhythmias in patients with type-2 diabetes mellitus. Issue 1 (2nd January 2021)

• Record Type: Journal Article
• Authors: Eren, Hayati; Kaya, Ülker; Öcal, Lütfi; Öcal, Aslı Gözek; Genç, Ömer; Genç, Selin; Evlice, Mert
• Is Part Of: Acta cardiologica. Volume 76:Issue 1(2021)
• Page Start: 67
• Page End: 75
• Publication Date: 2021-01-02
• Subjects: Fragmented QRS -- diabetes mellitus -- ventricular arrhythmia -- electrocardiography -- myocardial fibrosis -- diabetic cardiomyopathy; Cardiology -- Periodicals; Cardiology; Cardiologie -- Périodiques; Cardiology; Cardiologie; Periodicals; Periodicals; 616.12005
• DOI: 10.1080/00015385.2019.1693117
• Languages: English
• ISSNs: 0001-5385

Abstract

Abstract: Background: Ventricular arrhythmias (VAs) are frequent in diabetes mellitus (DM) patients. Myocardial fibrosis is one of the components of diabetic cardiomyopathy secondary to DM. Fragmented QRS (fQRS) on electrocardiography (ECG) has been shown to be a marker of myocardial fibrosis. In this study, we aimed to investigate the association between fQRS and complex VAs in patients with DM. Methods: Three hundred and thirty-six consecutive patients who were diagnosed with DM were included in the study. The control group consisted of 275 age- and sex-matched healthy individuals. ECG and transthoracic echocardiography were performed in all the patients. fQRS was defined as additional R' wave or notching/splitting of S wave in two contiguous ECG leads. All the patients underwent 24-h Holter monitoring and VAs were classified using Lown's scoring system. Lown class ≥ 3 VAs were considered as complex VAs. Results: As compared to the healthy individuals, prevalence of fQRS (37.5% vs. 6.9%, p < .001) and complex VAs (14% vs. 0%, p < .001) were significantly higher in patients with DM. Furthermore, complex VAs (28.4% vs. 6.4%, p < .001) were significantly higher in DM patients with fQRS. In multiple logistic regression analysis, DM duration (OR: 1.510, 95% CI:1.343 to 1.698; p < .001) and presence of fQRS (OR: 3.262, 95% CI: 1.443 to 7.376; p = .004) were independent predictors for complex VAs. Conclusions: The presence of fQRS may be associated with complex VAs in patients with DM. Therefore, fQRS may be used as a predictor of complex VAs and the risk of sudden death in patients with DM.