{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T15:59:29Z","timestamp":1740153569058,"version":"3.37.3"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The study was designed to investigate the effect of heart rate and pacing mode on QRS<\/jats:styled-content> fragmentation (f\u2010QRS<\/jats:styled-content>). Moreover, the usefulness of f\u2010QRS<\/jats:styled-content> in distinguishing patients with impaired left ventricular ejection function (EF<\/jats:styled-content>) and ventricular tachycardia (VT<\/jats:styled-content>) from patients with normal EF<\/jats:styled-content> was assessed.<\/jats:p><\/jats:sec>Methods<\/jats:title>Three hundred and six recipients, with dual\u2010chamber device, with intrinsic narrow or wide QRS<\/jats:styled-content> complex and preserved atrioventricular conduction were grouped into normal\u2010EF<\/jats:styled-content> or impaired\u2010EF VT<\/jats:styled-content>. We analyzed intrinsic narrow f\u2010QRS<\/jats:styled-content> and wide f\u2010QRS<\/jats:styled-content> as well as ventricular\u2010paced f\u2010QRS<\/jats:styled-content> following different heart rates (baseline, 100\u00a0bpm) and pacing modes.<\/jats:p><\/jats:sec>Results<\/jats:title>In the baseline state, overall, patients with impaired\u2010EF VT<\/jats:styled-content> (35\u00a0\u00b1\u00a09%), compared to those with normal\u2010EF<\/jats:styled-content>, had more f\u2010QRS<\/jats:styled-content> (56% vs 27%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>.001) and ventricular\u2010paced f\u2010QRS<\/jats:styled-content> (62% vs 16%, P\u00a0<\/jats:italic><\u00a0<\/jats:italic>.0001). Ventricular pacing conferred both at baseline and at higher heart rate more ventricular\u2010paced f\u2010QRS<\/jats:styled-content> in patients with impaired\u2010EF VT<\/jats:styled-content> than in normal\u2010EF<\/jats:styled-content> (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>.001). Detection of ventricular\u2010paced f\u2010QRS<\/jats:styled-content> markedly improved overall specificity (84%) and positive predictive value (91%) in identifying patients with impaired\u2010EF VT<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Increased heart rate or\/and ventricular pacing uncover QRS<\/jats:styled-content> fragmentations. Detection of ventricular\u2010paced f\u2010QRS<\/jats:styled-content> adds value toward noninvasive identification of patients with impaired\u2010EF VT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12060","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T19:18:40Z","timestamp":1523992720000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of heart rate and pacing mode on QRS<\/scp> fragmentation"],"prefix":"10.1002","volume":"34","author":[{"given":"Fani","family":"Zagkli","sequence":"first","affiliation":[{"name":"Cardiology Department Patras University Hospital Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanos","family":"Despotopoulos","sequence":"additional","affiliation":[{"name":"Cardiology Department Patras University Hospital Patras 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