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

Abstract

What is known and Objective: Although restoration of sinus rhythm is the integral part of the atrial fibrillation (Af) management, recurrence frequency of Af is high after cardioversion. However, little is known about the association of electrocardiography (ECG) parameters with Af recurrence after restoration of sinus rhythm. The present study aimed to investigate whether frontal plane QRS-T (fQRST) angle, as a marker of ventricular repolarization heterogeneity, predicts Af recurrence after successful pharmacological cardioversion.Methods: One hundred and sixty-five paroxysmal Af patients with an acute Af episode who underwent successful pharmacological cardioversion with intravenous amiodarone infusion were included into the study. Patients were divided into two groups according to presence or absence of in-hospital Af recurrence. The association between fQRST angle and Af recurrence was investigated.Results and discussion: Af recurrence was observed in 42 (25.4%) patients. The mean fQRST angle was significantly higher in patients with Af recurrence compared to those without Af recurrence (90 ± 45.8 vs. 51 ± 38.2, p < 0.001). Also, Af recurrence was more frequent in patients who had fQRST angle >90˚, compared to patients with fQRST angle ≤90˚ (54.1% vs. 13.7%, p < 0.001). Moreover, ROC curve analysis demonstrated that an increased fQRST angle >92.5˚ predicted in-hospital Af recurrence with a sensitivity of 76.2% and a specificity of 81.4% (AUC:0.728, p < 0.001).Furthermore, multivariate analysis demonstrated that fQRST angle was an independent predictor of in-hospital Af recurrence after successful pharmacological cardioversion (OR: 1.892, 95% CI: 1.361-2.917, p < 0.001). What is new and conclusion:As a parameter that can be easily calculated from automated ECG recordings, fQRST angle may be useful in the prediction of early Af recurrence after successful pharmacological cardioversion with amiodarone.

The Importance of Frontal QRS-T Angle in Predicting the Effectiveness and Success of Thrombolytic Therapy in Patients With Acute Pulmonary Embolism

“…In contrast, fQRS-T can be easily measured from the automatic report section of the ECG equipment and well matches the spatial QRS-T angle for risk calculation. Although there is no traditional upper limit for fQRS-T intervals, this value is often reported between 30 and 45 degrees [17]. Over the past decade, several observational studies have connected the QRS-T angle with sudden death and other fatal and pathological results [18,19].…”

Relationship Between Atrial Fibrillation Recurrence and Frontal QRS-T Angle After Effective Cardioversion

“…On the other hand, fQRS-T can be readily measurable from the automatic report section of the ECG equipment and well matches the spatial QRS-T angle for risk calculation. Despite the upper limit ranges for fQRS-T, the usual value is between 45° and 60° [16]. Numerous observational studies over the last decade have linked the QRS-T angle to cardiac mortality and other fatal consequences [17,18].…”

Cardiovascular diseases and frontal QRS-T angle

“…35 fQRSTa, readily determined from automated ECG recordings, may indicate early AF recurrence following amiodarone cardioversion. 36 fQRSTa predicts atherosclerosis in STEMI patients. 37 F(QRS-T) may predict SYNTAX score to determine early invasive approach in non-ST elevation myocardial infarction (NSTEMI) patients.…”