The relationship between electrocardiographic findings and left ventricular apical thrombus.

Persistent ST segment elevation, fragmented QRS (fQRS), and prominent R wave in lead aVR (Goldberger sign) are the parameters associated with ventricular aneurysm. The goal of this report was to examine the association with electrocardiographic findings (persistent ST elevation, QRS duration, LBBB, and Fragmented QRS [fQRS]) and LV apical thrombus in subjects following anterior MI. The study was a prospective and cross-sectional analysis that comprised of 220 consecutive subjects diagnosed after anterior MI. The echocardiographic features of patients were evaluated at least 6 weeks after anterior MI. A 12-point ECG was collected on all subjects admitted to the hospital. LBBB, persistent ST elevation, QRS duration and fQRS were evaluated in these patients. The LV ejection fraction (LVEF) was lower in the thrombus group compared to the non-thrombus group (27.2 ± 7.1/33.2 ± 10.0, p=0.008).  In patients with LV apical thrombus (LVAT); LBBB, persistent ST elevation, QRS duration and fQRS were higher compared to those without LVAT (p<0.05). We demonstrated that the electrocardiographic findings (persistent ST elevation, QRS duration, LBBB, and fQRS) were closely associated with LVAT, and these findings were used as indicators of LV thrombi in anterior MI patients.