Vol.22 No.2

Original Article

Frequency of fragmented QRS on ECG is increased in patients with rheumatoid arthritis without cardiovascular disease: a pilot study

Authors

Hasan Kadi1 , Ahmet Inanir2 , Abdulkadir Habiboglu2 , Koksal Ceyhan1 , Fatih Koc1 , Atac Çelik1 , Orhan Onalan1 , Sule Arslan2

  • Cardiology Department, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
  • Physical Medicine and Rehabilitation Department, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey
Received:

13 May 2011

Accepted:

10 June 2011

Published online:

5 July 2011

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Abstract

Myocardial fibrosis causes the fragmentation of QRS complexes (fQRS) on ECGs. We hypothesized that the frequency of fQRS could be more common in patients with rheumatoid arthritis (RA) than in control subjects. A total of 56 patients with RA were compared with 35 ageand gender-matched fibromyalgia subjects for fQRS. The fQRS was defined as the presence of an additional R wave, or notching of the R or S wave, or the presence of fragmentation in 2 contiguous leads corresponding to the territory of a major coronary artery. Patients with bundle block on ECG and cardiovascular disease were excluded. Twenty-one patients (37.5%) in the RA group had fQRS, while two patients in the control group (5.7%) had fQRS (p = 0.001). No differences were found between the groups in terms of age, gender, or drug use. Duration of disease-years (interquartile range [IQR])-was 10 (8) in the fQRS (+) group, while it was 5 (2) in the fQRS (-) group (p<0.001). Multivariate logistic regression analysis revealed that duration of disease was associated with the presence of fQRS (B = 1.5, odds ratio = 4.5, p = 0.004, 95% confidence interval = 1.6-12.7). We found that fQRS on ECG was more common in patients with RA without cardiovascular disease than in age- and gender-matched control subjects.

Key words

ECG - Fragmented QRS - Myocardial fibrosis - Rheumatoid arthritis