In our study we demonstrate that presence of either Q-wave and or fQRS complexes on a 12-lead ECG in patients with suspected cardiac involvement of sarcoidosis may indicate the presence of greater infiltrative myocardial disease by cardiac magnetic resonance imaging. Fragmented QRS complexes (fQRS) on 12-lead ECG are a marker of greater myocardial scarring and were observed in some sarcoid patients (pts).

To evaluate the significance of presence of fQRS on 12-lead ECG compared to Gadolinium-delayed enhancement images (GDE) -Cardiac magnetic resonance (CMR) imaging.

12 pts (mean age 52 ± 11 year, 42% male) were studied. fQRS, Q wave and bundle branch block were present in 6 (50%), 2 (17%) and 1 (8%) pts, respectively. 5 (45%) pts had abnormal GDE in CMR suggestive of possible cardiac involvement of sarcoidosis. All pts had midwall GDE except one patient had midwall GDE as well as subenodcardial GDE which represented an old known myocardial infarction. 67% of pts (n = 4) with fQRS had abnormal GDE vs. 17% of pts (n = 1) without fQRS had abnormal GDE; p = 0.09. Whereas the abnormal GDE was found in 71% of pts (n = 5) with either Q wave or fQRS vs. none (0%) of pts without Q wave or fQRS; p = 0.008.

The presence of either Q-wave and or fQRS complexes on a 12-lead ECG in patients with suspected cardiac involvement of sarcoidosis may indicate the presence of greater infiltrative myocardial disease by GDE-CMR imaging.