<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-9940</journal-id>
<journal-title><![CDATA[Archivos de cardiología de México]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Cardiol. Méx.]]></abbrev-journal-title>
<issn>1405-9940</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Cardiología Ignacio Chávez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-99402018000200124</article-id>
<article-id pub-id-type="doi">10.1016/j.acmx.2016.12.008</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[QRS-fragmentation: Case report and review of the literature]]></article-title>
<article-title xml:lang="es"><![CDATA[Fragmentación del QRS: reporte de caso y revisión de la literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Illescas-González]]></surname>
<given-names><![CDATA[Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araiza-Garaygordobil]]></surname>
<given-names><![CDATA[Diego]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sierra Lara]]></surname>
<given-names><![CDATA[Jorge Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramirez-Salazar]]></surname>
<given-names><![CDATA[Aristoteles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sierra-Fernández]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alexanderson-Rosas]]></surname>
<given-names><![CDATA[Erick]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,National Institute of Cardiology Ignacio Chávez  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,National Institute of Cardiology Ignacio Chávez  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,National Institute of Cardiology Ignacio Chávez  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2018</year>
</pub-date>
<volume>88</volume>
<numero>2</numero>
<fpage>124</fpage>
<lpage>128</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-99402018000200124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-99402018000200124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-99402018000200124&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Fragmentation of QRS complex (QRSf) is an easily evaluable, non-invasive electrocardiographic parameter that represents depolarisation anomalies and has been associated with several adverse outcomes, such as sudden death, fibrosis, arrhythmic burden, and a worse prognosis in different conditions, including coronary artery disease (CAD). The case is presented of a 69-year old male referred due to symptoms of chronic stable angina. His electrocardiogram showed sinus rhythm, absence of Q waves, but the presence of QRSf in the inferior leads and V4-V6. A Tc-99 myocardial perfusion SPECT scan revealed a fixed perfusion defect in the inferolateral region, corresponding to the finding of QRSf. QRSf is an easily valuable electrocardiographic marker with relative sensitivity, but poor specificity. Its routine clinical application could contribute to an increase in the suspicion of coronary artery disease.  Conclusion:  The presence of fragmented QRS represents distortion of signal conduction and depolarisation, which is related to myocardial scar or myocardial fibrosis. © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La fragmentación del QRS (fQRS) es un parámetro electrocardiográfico fácilmente evaluable que representa anomalías de despolarización y que se ha asociado a varios resultados adversos como muerte súbita, fibrosis, carga arrítmica y peor pronóstico en diferentes afecciones, incluyendo la enfermedad arterial coronaria (EAC). Se presenta el caso de un hombre de 69 años referido para estudio por síntomas compatibles con angina de esfuerzo. El electrocardiograma mostró ritmo sinusal, sin ondas Q, pero con fQRS en la cara inferior y en V4-V6. Un SPECT cardiaco con Tecnecio-99 demostró fijo inferior e inferolateral, correspondiente al territorio electrocardiográfico de fQRS. La fQRS es un marcador electrocardiográfico fácilmente valorable, relativamente sensible, aunque poco específico, el cual puede contribuir en la práctica clínica a aumentar la probabilidad de sospecha de una enfermedad arterial coronaria. © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (https://creativecommons.org/licenses/by-nc-nd/4.0/).]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Fragmentation of QRS]]></kwd>
<kwd lng="en"><![CDATA[Sudden death]]></kwd>
<kwd lng="en"><![CDATA[Prognosis]]></kwd>
<kwd lng="en"><![CDATA[Coronary artery disease]]></kwd>
<kwd lng="en"><![CDATA[Cardiomyopathy]]></kwd>
<kwd lng="en"><![CDATA[México]]></kwd>
<kwd lng="es"><![CDATA[Fragmentación del QRS]]></kwd>
<kwd lng="es"><![CDATA[Muerte súbita]]></kwd>
<kwd lng="es"><![CDATA[Pronóstico]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad arterial coronaria]]></kwd>
<kwd lng="es"><![CDATA[Cardiomiopatía]]></kwd>
<kwd lng="es"><![CDATA[México]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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