Value Of Fragmented QRS Complex In The Diagnosis Of Acute Myocardial Infarction

Background and Objective Up to now the detection rate and diagnostic value of the fragmented QRS complex appeared in ECG of patients with acute myocardial infarction are in dispute.This present study was assigned as discussing prospectively the detection rate and clinical significance. Methods200patients admitted with AMI who underwent cardiac catheterization in Affiliated Hospital of Binzhou Medical College from May2009to July2012were included in this sduty,excluding valvular heart disease, myocardiopathy, left ventricle hypertrophy caused by hypertention, complete and incomplete bundle branch block and so on that probably caused fragmented QRS complex.According to the morphology of QRS complex,the patients were divided into three groups:group with pathological Q, group with fragmented QRS complex, group with pathological Q and fragmented QRS complex.The ECG was analyzed based on myocardial infarction parts and types.100inpatients whose coronary angiography were negative were selected as control group. Results In200acute myocardial infarction cases, the pathological Q wave was present in166(83.0%)patients,the fragmented QRS was present in105(52.5%)patients,the pathological Q wave and fragmented QRS was present in87(43.5%)patients.The sensitivity of pathological Q in diagnosing acute myocardial infarction (83.0%) was significantly higher than fragmented QRS (52.5%) or pathological Q wave and fragmented QRS(43.5%)(P<0.05);About the specificity of acute myocardial infarction diagnosis,pathological Q wave90.0%, fragmented QRS87.0%, pathological Q wave and fragmented QRS99.0%. The specificity of pathological Q wave and fragmented QRS in diagnosing acute myocardial infarction (99.0%) was higher than pathological Q (90.0%) or fragmented QRS (87.0%)(P>0.05). Conclusion Fragmented QRS has evidently worse sensitivity and negative predictive but slightly lower specificity and positive predictive value in comparision to the pathological Q wave for identifying acute myocardial infarction..Both have higher specificity and positive predictive value.