Clinical & Experimental Cardiology
Open Access

Abstract

Relationship of Fragmented Wide QRS Complexes with Coronary Atherosclerosis in Patients with Left Bundle Branch Block

Nermin Bayar, Goksel Cagirci, Serkan Cay, Zehra Erkal, Isa Oner Yuksel, Erkan Koklu, Gorkem Kus and Sakir Arslan

Objective: The non-invasive tests used in the diagnosis of Coronary Artery Disease (CAD) in patients with Left Bundle Branch Block (LBBB) are of limited use. The aim of this study is to investigate the relationship between the presence of Fragmented wide QRS [f-wQRS] and coronary atherosclerosis in patients with LBBB.

Methods: This retrospective study included 75 patients who were admitted to our clinic with exertional chest pain and LBBB on electrocardiography and for whom it was decided to obtain coronary angiography as a result of clinical evaluation or positive scintigraphic results. The presence of f-wQRS was investigated in patients' electrocardiography prior to coronary angiography. Gensini score was calculated by examining the patients' coronary angiography records. Patient who had 75% and more stenosis in at least one coronary artery was defined as an obstructive CAD.

Results: Thirty-nine patients had obstructive CAD. Gensini score was higher in the group with obstructive CAD [34.0 and 6.3, respectively, p<0.001]. Significant difference was found between the patients with obstructive CAD and patients without obstructive CAD for the presence of f-wQRS [82.1% and 8.3%, respectively, p<0.001]. Gensini score was found to be higher in patients with f-wQRS compared to without f-wQRS [34.0 and 7.0, p<0.001, respectively].

Conclusion: In our study, the presence of f-wQRS in patients with LBBB was associated with the presence and severity of obstructive CAD. In this patient group, searching for f-wQRS on surface electrocardiography can be considered as a new risk factor associated with CAD due to its easy evaluation, being an inexpensive and non-invasive method.