University of Oulu

M. Anette E. Haukilahti, Lauri Holmström, Juha Vähätalo, Jani T. Tikkanen, Henri K. Terho, Antti M. Kiviniemi, E. Samuli Lepojärvi, Mikko Tulppo, Juha S. Perkiömäki, Olavi H. Ukkola, Olli Anttonen, Aapo L. Aro, Tuomas Kerola, Harri Rissanen, Paul Knekt, M. Juhani Junttila, Heikki V. Huikuri, Tuomas V. Kenttä, Gender differences in prevalence and prognostic value of fragmented QRS complex, Journal of Electrocardiology, Volume 61, 2020, Pages 1-9, ISSN 0022-0736,

Gender differences in prevalence and prognostic value of fragmented QRS complex

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Author: Haukilahti, M. Anette E.1; Holmström, Lauri1; Vähätalo, Juha1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Finland
2Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
3Division of Cardiology, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
4Finnish National Institute for Health and Welfare, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 3.4 MB)
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Language: English
Published: Elsevier, 2020
Publish Date: 2020-07-02


Background: Fragmented QRS (fQRS) on 12-lead electrocardiogram (ECG) is associated with scarred myocardium and adverse outcome. However, the data on gender differences in terms of its prevalence and prognostic value is sparse. The aim of this study was to evaluate whether gender differences in fQRS exist among subjects drawn from populations with different risk profiles.

Methods: We analyzed fQRS from 12-lead ECG in 953 autopsy-confirmed victims of sudden cardiac death (SCD) (78% men; 67.0 ± 11.4 yrs), 1900 coronary artery disease (CAD) patients with angiographically confirmed stenosis of ≥50% (70% men; 66.6 ± 9.0 yrs, 43% with previous myocardial infarction [MI]), and in 10,904 adults drawn from the Finnish adult general population (52% men; 44.0 ± 8.5 yrs).

Results: Prevalence of fQRS was associated with older age, male sex and the history and severity of prior cardiac disease of subjects. Among the general population fQRS was more commonly found among men in comparison to women (20.5% vs. 14.8%, p < 0.001). The prevalence of fQRS rose gradually along with the severity of prior cardiac disease in both genders, yet remained significantly higher in the male population: subjects with suspected or known cardiac disease (25.4% vs. 15.8% p < 0.001), CAD patients without prior MI (39.9% vs. 26.4%, p < 0.001), CAD patients with prior MI (42.9% vs. 31.2%, p < 0.001), and victims of SCD (56.4% vs. 44.4%, p < 0.001).

Conclusions: The prevalence of QRS fragmentation varies in different populations. The fragmentation is clearly related to the underlying cardiac disease in both genders, however women seem to have significantly lower prevalence of fQRS in each patient population in comparison to men.

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Series: Journal of electrocardiology
ISSN: 0022-0736
ISSN-E: 1532-8430
ISSN-L: 0022-0736
Volume: 61
Pages: 1 - 9
DOI: 10.1016/j.jelectrocard.2020.05.010
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The University of Oulu Scholarship Foundation, Juho Vainio Foundation, The Maud Kuistila Memorial Foundation, The Finnish Medical Foundation, Finnish Foundation for Cardiovascular Research, The Paulo Foundation, Aarne Koskelo Foundation, Päivikki and Sakari Sohlberg Foundation.
Copyright information: © 2020 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (