Frontal plane QRS-T angle may be a predictor for post-coronary artery bypass graft surgery atrial fibrillation

Abstract

SUMMARY BACKGROUND: New-onset postoperative atrial fibrillation (POAF) is the most common arrhythmia following coronary artery bypass graft surgery (CABG) and is associated with prolonged hospitalization, stroke, and mortality. The frontal plane QRS-T [f(QRS-T)] angle, which is defined as the angle between the directions of ventricular depolarization (QRS-axis) and repolarization (T-axis), is a novel marker of ventricular repolarization heterogeneity. The f(QRS-T) angle is associated with adverse cardiac outcomes. In light of these findings, in this study, we aimed to investigate the potential relationship between the f(QRS-T) angle and POAF. METHODS: 180 patients who underwent CABG between August 2017 and September 2018 were included in the study retrospectively. Two groups were established as patients who preserved postoperative sinus rhythm (n=130) and those who developed POAF (n=50). The f(QRS-T) angle and all other data were compared between groups. RESULTS: The fF(QRS-T) angle (p<0.001), SYNTAX score (p=0.039), serum high-sensitivity CRP levels (p=0.026), mean age (p<0.001), electrocardiographic left ventricular hypertrophy rate (LVH) (p=0.019), and hypertension rate (p=0.007) were higher, and the mean left ventricular ejection fraction (LVEF) (p<0.001) was lower in the POAF group. Multivariable logistic regression analyses demonstrated that lower LVEF (p=0.004), LVH (p=0.041), and higher age (p=0.008) and f(QRS-T) angle (p<0.001) were independently associated with POAF. CONCLUSIONS: High f(QRS-T) angle level is closely associated with the development of POAF. The f(QRS-T) angle can be a potential indicator of POAF.

Cardiovascular diseases and frontal QRS-T angle

“…The fQRS-Ta can be a possible sign of POAF. 34 Amiodarone affects fQRS-Ta. FQRS-Ta may be readily determined from automated ECG recordings and used to monitor intravenous amiodarone medication.…”

Frontal plane QRS‐T angle predicts early recurrence of acute atrial fibrillation after successful pharmacological cardioversion with intravenous amiodarone

“…[21][22][23] Moreover, a significant association between abnormal fQRST angle and emergence of Af has been reported. 12,24 Also, a recent study revealed that fQRST angle may be useful in the monitoring of intravenous amiodarone infusion for pharmacological cardioversion of Af. 25 However, the importance of fQRST angle in patients with acute Af, and its association with The present study has some limitations.…”