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Abstract Fragmented QRS complex in patients with coronary artery disease (CAD) was associated with myocardial conduction block due to myocardial scar detected by myocardial single photon emission tomography (SPECT). (Das et al., 2006). Fragmented QRS was defined by an additional R wave (R’) or notching within the QRS complex. Fragmented QRS improved identification of prior myocardial infarction in patients who are being evaluated for CAD. Fragmented QRS can be caused by zigzag conduction around the scarred myocardium, resulting in multiple spikes within the QRS complex (Morita et al., 2008). |