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Erschienen in: Herzschrittmachertherapie + Elektrophysiologie 3/2015

01.09.2015 | Schwerpunkt

Fragmentierter QRS-Komplex

Bedeutung in der klinischen Praxis

verfasst von: Alexander Steger, Daniel Sinnecker, Anna Berkefeld, Alexander Müller, Josef Gebhardt, Michael Dommasch, Katharina M. Huster, Petra Barthel, Georg Schmidt

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 3/2015

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Zusammenfassung

Der QRS-Komplex bildet die Erregungsausbreitung des ventrikulären Myokards elektrokardiographisch ab. Ist sie ungestört, findet sich ein unauffällig konfigurierter QRS-Komplex von normaler Dauer. Ist sie aufgrund pathologischer Veränderungen gestört, kommt es zu einer Verbreiterung des QRS-Komplexes. Bei Unterbrechung eines Tawara-Schenkels findet sich das Bild eines klassischen Schenkelblocks. Ist eine Zuordnung zu einem klassischen Schenkelblock aufgrund einer atypischen QRS-Konfiguration nicht möglich und finden sich Einkerbungen der R- oder der S-Zacken, spricht man von fragmentierten QRS-Komplexen. Das pathophysiologische Korrelat der fragmentierten QRS-Komplexe ist vielfältig: Es kann sich um Myokardnarben im Rahmen einer koronaren Herzerkrankung, um fibrotische Myokardareale anderer Genese, um primäre Herzerkrankungen oder systemische Erkrankungen mit kardialer Beteiligung handeln. Auch Funktionsstörungen auf zellulärer Ebene, z. B. von Ionenkanälen, können mit fragmentierten QRS-Komplexen einhergehen. Neben der diagnostischen Bedeutung werden fragmentierte QRS-Komplexe zunehmend auch prognostische Eigenschaften zugesprochen, z. B. bei der Identifikation von Hochrisikopatienten bei koronarer Herzerkrankung, Kardiomyopathien, Brugada-Syndrom und Long-QT-Syndrom. Allerdings können fragmentierte QRS-Komplexe auch beim Gesunden beobachtet werden.
Fußnoten
1
Dem Perfusionsgebiet einer Koronararterie entsprechend.
 
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Metadaten
Titel
Fragmentierter QRS-Komplex
Bedeutung in der klinischen Praxis
verfasst von
Alexander Steger
Daniel Sinnecker
Anna Berkefeld
Alexander Müller
Josef Gebhardt
Michael Dommasch
Katharina M. Huster
Petra Barthel
Georg Schmidt
Publikationsdatum
01.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 3/2015
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI
https://doi.org/10.1007/s00399-015-0390-6

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