Int Cardiovasc Res J.2017;11( 3):115-118.icrj.10239 Zahra Alizadeh Sani 1 , Ali Vasheghani farahani 1 , Zahra Khajali 1 , Majid Jamshidi 1 , Mahshid Hesami 1 , Hamidreza Fallahabadi 1 , Mousa Alimohammadi 1 , Azin Seif 2 , Majid Nejati 3 , Mohaddeseh Behjati 1, 4, * 1 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran 2 Electrophysiology Department, Tehran University of Medical Sciences, Tehran, IR Iran 3 Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran 4 Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR Iran ARTICLE INFO Article Type: Research Article Article History: Received: 28 Dec 2016 Revised: 28 Apr 2017 Accepted: 09 May 2017 Keywords: Tetralogy Fallot Myocardial Fibrosis ABSTRACT Background: Repair of tetralogy of fallot (TOF) is associated with difuse myocardial fbrosis. Cardiac magnetic resonance imaging (CMR) can visualize the areas with myocardial fbrosis. Presence of fragmented QRS (fQRS) implies the presence of the underlying myocardial scar. Despite the strong association between fQRS and myocardial pathologies, the impact of fQRS with myocardial fbrosis in post-TOF correction is unknown. Objectives: Here, we evaluated the possible predictive role of fQRS in repaired TOF cases and its relationship with cardiac function. Patients and Methods: Tirty two patients with previous history of repaired TOF were enrolled. Te extent of fQRS was evaluated according to the number of leads with fQRS. Afer electrocardiographic evaluation, the participants underwent CMR. Results: Results showed a signifcant relationship between the right ventricular (RV) systolic diameter and fQRS (P = 0.014). Also, an inverse linear relationship was found between the number of fQRS edges and RVEF (r = 0.77, P = 0.0001). Te mean QRS duration in those with positive and negative fQRS was 132 mm and 115.8 mm (P = 0.0001). Furthermore, a linear correlation was observed between the number of edges and the percentage of scar tissue (r = 0.88, P = 0.001). However, no relevance between gender and fQRS was detected (P = 0.26), and the relationship between RV diastolic diameter and fQRS was not signifcant (P = 0.1). Tus, fQRS could be used as a marker of RV systolic dysfunction in patients with tetralogy of fallot. Conclusions: We suggested the fQRS as a surrogate indicator of RV dysfunction in repaired TOF patients and showed that diagnostic and prognostic information of the patients were available by fQRS. *Corresponding author: Mohaddeseh Behjati, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Tel: +98-9132307657, E-mail: behjati@med.mui.ac.ir 1. Background Prevalence of TOF is about 3 in every 10 thousand live birth (1). Repair of this congenital cyanotic heart disease is associated with diffuse myocardial fbrosis (2). Determination of myocardial fbrosis could be made through various image modalities like echocardiography. Since echocardiography is unsuccessful for visualizing of all the heart segments, cardiac magnetic resonance imaging (CMR) can visualize the unseen cardiac areas fully such as all segments of the left ventricle. Also, CMR can show the area of myocardial fbrosis (3). However, this technique is not always an appropriate choice because of its cost and availability. Electrocardiography as a fast and easy method for determination of cardiac pathologies is another possible choice. Presence of QRS complex abnormalities implies the presence of underlying myocardial scar and can represent conduction disturbances (4). Fragmented QRS Correlation of Fragmented QRS with Right Ventricular Indexes and Fibrosis in Patients with Repaired Tetralogy of Fallot, by Cardiac Magnetic Resonance Imaging