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Fragmented Left Sided QRS in Absence of Bundle Branch Block: Sign of Left Ventricular Aneurysm

Background: A left ventricular aneurysm (LVA) occurs between 3.5% and 9.4% of all cases of acute myocardial infarction. A fragmented left sided QRS (RSR` pattern or its variant RSr`, rSR`, or rSr`) without evidence of bundle branch block (QRS duration ≤120 ms) on the ECG may be associated with a significant myocardial scar, which is the characteristic of a LVA. We, therefore, postulate that fragmented QRS (RSR` pattern or its variant) in the left sided leads (I, aVL, V3 to V6) may be a useful sign of LVA.