Fragmented QRS: Simple ECG Prognostic Marker

Fragmented QRS:

Simple ECG Prognostic Marker


Fragmented QRS Definition

☂️In presence of Narrow QRS (<80 ms) :-


fQRS is defined as

• Additional R wave (R’) or notching of R or S wave or

• More than one R’ in two contiguous leads

corresponding to a major coronary artery.

☂️In presence of Wide complex QRS (>120 ms):-


fQRS is defined as

• More than two notches in the R or S wave in two or

• More contiguous leads are necessary to qualify as fQRS.

Contiguous leads mean

Anterior leads (V 1 -V 5 ),

Lateral leads (I, aVL, and V 6 ), or

Inferior leads (II, III, and aVF).

♉️Fragmented QRS

indicates heterogeneous depolarization of ventricular myocardium occur due to ischemia, fibrosis, or scar.

♎️Fragmented QRS

marker of coronary microvascular dysfunction. In the context of epicardial coronary artery disease, it is associated with multivessel disease and greater incidence of cardiac events.

♒️Fragmented QRS

indicator of higher incidence of arrhythmias and sudden death in arrhythmic right ventricular dysplasia, Brugada syndrome, and acquired long QT syndrome.

♑️Fragmented QRS

Its regression following cardiac resynchronization therapy suggests electrical reverse remodeling.

♋️Fragmented QRS

Marker of myocardial involvement in congenital ht diseases and is helpful in diagnosing subclinical cardiac involvement in various systemic diseases.


the presence of fragmented QRS (fQRS) on a routine (ECG) can give reasonable impression about severity of cardiac involvement in cardiac and systemic diseases.