Aim To investigate the relationship between fragmented QRS wave (fQRS) of the classification of coronary collateral circulation and the improvement of heart function after percutaneous coronary intervention (PCI) in patients with chronic total occlusion. Methods 245 cases of occlusion patients were included from January 2013 to December 2016 in Shengjing Hospital of China Medical University, to statistically analyse the biochemical indexes, electrocardiogram, interventional data, Rentrop classification of collateral circulation, preoperative and postoperative heart function. Patients were divided into fragmented QRS group (fQRS group, n＝108) and no fragmentation of QRS group (nfQRS group, n＝137) according to the state QRS wave in electrocardiogram, to analyse the difference of fQRS wave, classification of collateral circulation, and the improvement of heart function in 6 month and 1 year after the operation in the two groups. Results The level of collateral circulation in patients of fQRS wave was higher than the nfQRS group, the ventricular ejection fraction and 6 minutes walk test distance were increased after PCI treatment in the two groups of patients, but the left ventricular end diastolic volume index and the brain natriuretic peptide were decreased, the above index change more significantly in fQRS group compared to nfQRS group, the difference was statistically significant, and the collateral circulation classification and the improvement of heart function were positively correlated. Conclusion In coronary chronic total occlusion patients, fQRS was positively related to classification of collateral circulation, percutaneous coronary interventional therapy can improve heart function in patients with chronic total occlusion, and the heart function in patients with fQRS were improved obviously.