Correlated Research On Patients Between Fragmented QRS Complex And ST-segment Elevation Myocardial Infarction

Objective: The purpose of this paper is to analyze the clinical relevance of patients with fragmented QRS Complex and ST-segment elevation myocardial infarction(STEMI),including the occurrence and position of f QRS,and the scope of coronary artery stenosis,myocardial infarction area as well as the occurrence of adverse cardiovascular events,so as to evaluate the clinical value of f QRS on diagnosing Coronary Artery Disease(CAD)and predicting the prognosis of STEMI patients.Methods: Selected 142 qualified STEMI patients' medical records from January,2015 to December,2016,all of which were inspected through emergent Coronary Arteriography(CAG)and were divided into two groups according to whether their body surface ECG showed f QRS complex(84 cases with f QRS wave as experimental group,and 58 cases without f QRS wave as control group).All of the patients' s general information,risk factors,biochemical indexes,electrocardiogram results,coronary angiographic results,heart color doppler ultrasound report,cardiac functional grading,HRV,occurrence of cardiovascular adverse events during hospitalization,and other indexes were recorded.According to the degree of stenosis of the three great vessels shown on coronary angiographic results(stenosis?50%),the experiment were divided into single branch group,double branches group and three branches group,to compare the proportion of patients with and without f QRS wave.According to the myocardio infarction location through ST-segment elevation shown on the electrocardiogram,the experiment were divided into groups of front wall,side wall and inferior wall,to compare the proportion of patients with and without f QRS wave;and compare the occurrence of adverse cardiovascular events in groups with and without f QRS wave.Results: There is no obvious statistical difference between the two groups' general information and major cardiovascular diseases risk factors(P > 0.05).The occurring rate of f QRS of STEMI patients was higher than pathological Q wave,the difference of which has statistical significance(P<0.05).The detective rate of f QRS in inferior wall is the highest.And comparatively,its occurring rate in inferior wall is more statistically meaningful(P<0.05),on the contrary,the detective rate on the front wall and side wall has no statistical significance(P>0.05).Comparing the two groups during hospitalization,experimental group's occurrence rates of triple-vessel lesion,Killip classification??,malignant arrhythmia,cardiac death are all higher than control group with statistically significant difference(P<0.05);however,single vessel lesion,double vessels lesion,Killip classification??,acute left heart failure,cardiac shock shows no significant difference between the two groups(P>0.05).Patients' LVEF and SDNN in experiment group are both lower than control group with significant difference(P<0.05).Conclusion: 1.In STEMI patients,the occurrence rate of FQRS was obviously higher than pathological Q wave,moreover,f QRS wave is more common in inferior myocardial infarction.This not only provides a harmless and reliable measurement for MI,but also has a certain predictive value for CAD's clinical diagnosis.2.f QRS wave reflects CAD patients' number of coronary artery vascular lesions,which can initially diagnose the coronary artery disease of AMI patients and provide clues for the clinical treatment.3.The appearance of f QRS wave in electrocardiogram can be used to predict STEMI patients' heart function and heart rate variability,and have a certain predictive value for STEMI patients' adverse cardiovascular events after PCI,which can be seen as an independent predictive factor for the cardiac death of STEMI patient.