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Sistolik Sol Kalp Yetmezliği Olan Hastalarda Fragmante QRS ile ICD Şokları Arasındaki İlişki

The Association Between Fragmented QRS and ICD Shocks in Patients with Left Ventricular Systolic Heart Failure

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2013

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Abstract (2. Language): 
Objective: The relationship between fragmented QRS (fQRS) and mortality, ventricular arrhythmias in patients left ventri-cular systolic dysfunction has been studied and the results have been conflicting. In our study, we aimed to find the association between implantable cardioverter defibrillator (ICD) shocks and fQRS in patients who had functional capa-city below 3and was not on antiarrhythmic drugs. Method: We consecutively included 156 systolic heart failu-re patients who applied to our clinic for routine clinic follow up. All patients had been implanted ICD for more than 1 year. All ICDs were interrogated for arrhythmic episodes. Patients were divided into two groups according to presence of fQRS. Results: Patients in fQRS group had more shock events (p: 0.001). After regression analyze carried out fQRS was found to be predictor of shock events both for invariable (OR: 8.2 (3.8-9.8), p>0.001) and multivariable analyzes (OR: 3.8 (2.1-7.9), p>0.001). Conclusion: fQRS predicted shock events in patients who had functional capacity below 3 and were not on anti-arrhythmic therapy. The tendency for arrhythmic events seems as an important finding for this group of patients for clinical approach.
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Abstract (Original Language): 
Amaç: Sol ventrikül sistolik disfonksiyonu olan hastalarda fragmente QRS’in (fQRS) mortalite ve ventriküler aritmi ile ilişkisine dair farklı bilgiler mevcuttur. Biz çalışmamızda fQRS’in fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan implante edilebilir şok cihazı (ICD) taşıyan hasta grubundaki yaşanmış şok olayları ile ilişkisini saptamak istedik. Yöntem: Çalışmamız 1 yılı aşkın süredir ICD implante edilmiş fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan rutin klinik kontrollere gelen 156 sistolik kalp yetmezliği hastasını kapsamaktadır. Tüm hastaların ICD kontrolleri daha önceden yaşamış oldukları artimik olaylar için yapılmıştır. Hastalar fQRS varlığına göre ikiye ayrılıp analizler yapılmıştır. Bulgular: Fragmantasyon olan ve olmayan grup karşılaştırıl-dığı zaman fragmantasyon olan grupta anlamlı düzeyde şok olayı vardı (p: 0.001). Regresyon analizi yapıldığında frag-mantsyon varlığının hem şoku predikte ettiği hem tek (Odds oranı: 8.2 (3.8-9.8), p>0.001) hem de çok değişkenli analiz regresyon analizi ile saptanmıştır (Odds oranı: 3.8 (2.1-7.9), p>0.001). Sonuç: Fonksiyonel kapasitesi 3 altında olan ve herhangi antiaritmik ilaç kullanmayan hastalarda fQRS varlığı cihaza bağlı şok olaylarını predikte etmektedir. Bu bulgu fQRS’in bu grup hastalarda aritmik olaylara yatkınlığı göstermesi klinik yaklaşım açısından önemli gözükmektedir.
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