Fragmented QRS – Its significance

Fragment QRS (fQRS) complex is a myocardial conduction abnormality that indicates myocardial scar. It is defined as additional notches in the QRS complex. Though initially fQRS was defined in the setting of normal QRS duration (<120 m s), later it has been expanded to include conditions with wide QRS complexes as in bundle branch block, ventricular ectopy and paced rhythm, when more than 2 notches are present. It is an important, yet often overlooked marker of mortality and arrhythmic events in many cardiac diseases. The significance of fQRS lies in the fact that it just requires a surface ECG for its recording and the value of information about the condition of the heart it dispenses based on the clinical setting. We review the role of fQRS in predicting adverse cardiac events in various conditions.