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- Title
Clinical Application of the QRS-T Angle for the Prediction of Ventricular Arrhythmias in Patients with the Fontan Palliation.
- Authors
Tran, Tuong-Vi; Cortez, Daniel
- Abstract
Fontan palliation patients are at risk for ventricular arrhythmias post-operatively. This study aimed to evaluate whether differences in the spatial QRS-T angle can reliably predict ventricular arrhythmias in patients who had undergone Fontan palliation. A total of 117 patients who had the Fontan palliation and post-Fontan catheterization were included. Ventricular arrhythmias were identified in nine patients. Measurements of ECG parameters including QRS vector magnitude, QRS duration, corrected QT interval, and spatial peaks QRS-T angles were performed, and compared between those with and without ventricular arrhythmias. The only ECG parameter to distinguish those with versus those without VA was the SPQRS-T angle ( p < 0.001), which at a cut-off value of 102.9° gave sensitivity, specificity, positive and negative predictive values of 100.0, 57.0, 17.6 and 100.0%, respectively. Only the spatial peaks QRS-T angle differentiated those with and without ventricular arrhythmia development with a univariate HR 1.237 (95% CI 1.021-1.500) and a multivariate HR of 1.032 (1.009-1.056) when catheter measured parameters were taken into account. In Fontan patients, the spatial peaks QRS-T angle is a significant independent predictor of ventricular arrhythmias. Clinical usefulness of this parameter remains to be seen and should be tested prospectively.
- Subjects
VENTRICULAR arrhythmia; PALLIATIVE treatment; ELECTROCARDIOGRAPHY; CATHETERIZATION; VECTORCARDIOGRAPHY; HUMAN abnormalities; DIAGNOSIS
- Publication
Pediatric Cardiology, 2017, Vol 38, Issue 5, p1049
- ISSN
0172-0643
- Publication type
Article
- DOI
10.1007/s00246-017-1618-5