J Cardiovasc Thorac Res. 2014;6(2):85-89.
doi: 10.5681/jcvtr.2014.019
PMID: 25031822
PMCID: PMC4097857
  Abstract View: 599
  PDF Download: 933

Review Article

Variations of QRS Morphology in Patients with Dilated Cardiomyopathy; Clinical and Prognostic Implications

Taylan Akgun 1 * , Sedat Kalkan 1, Mustafa Kursat Tigen 2

1 Kartal Kosuyolu Heart & Research Hospital, Department of Cardiology, Istanbul, Turkey
2 Marmara University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey


The QRS represents the simultaneous activation of the right and left ventricles, although mostof the QRS waveform is derived from the larger left ventricular musculature. Although normalQRS duration is <100 millisecond (ms), its duration and shape are quite variable from patient topatient in idiopathic dilated cardiomyopathy (IDCM). Prolongation of QRS occurs in 14% to 47%of heart failure (HF) patients. Left bundle branch block (LBBB) is far more common than rightbundle branch block (RBBB). Dyssynchronous left ventricular activation due to LBBB and otherintraventricular conduction blocks provides the rationale for the use of cardiac resynchronizationtherapy with biventricular pacing in patients with IDCM. Fragmented QRS (fQRS) is a markerof depolarization abnormality and present in significant number of the patients with IDCM andnarrow QRS complexes. It is associated with arrhythmic events and intraventricular dyssynchrony.The purpose of this manuscript is to present an overview on some clinical, echocardiographic andprognostic implications of various QRS morphologies in patients with IDCM.
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