Cortez Daniel, Sharma Nandita, Imundo Jason R, Cohen Mark
University of Colorado, Aurora, CO, USA; Electrophysiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA; Clinical Sciences, Lund University, Lund, Sweden.
Electrophysiology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
J Electrocardiol. 2017 Sep-Oct;50(5):576-583. doi: 10.1016/j.jelectrocard.2017.03.015. Epub 2017 Mar 14.
Fontan palliation patients are at risk for atrial arrhythmias post-operatively. This study aimed to evaluate whether differences in depolarization vector magnitude or spatial P-R angle can reliably predict atrial arrhythmias in patients who had undergone Fontan palliation.
A total of 115 patients who had Fontan palliation and post-Fontan catheterization were included. Atrial arrhythmias were identified in 14 patients. Measurements of ECG parameters including QRS vector magnitude, P-R duration, spatial QRS-T angle and spatial P-R angle were performed, and compared between those with and without atrial arrhythmias.
Only the QRSvm independently differentiated those with and without atrial arrhythmias with multivariate HR of 0.743 (95% CI 0.581 to 0.951).
In Fontan patients, the QRSvm was the only significant independent predictor of atrial arrhythmias.
Fontan姑息手术患者术后有发生房性心律失常的风险。本研究旨在评估去极化向量大小或空间P-R角的差异是否能可靠预测接受Fontan姑息手术患者的房性心律失常。
共纳入115例行Fontan姑息手术及Fontan术后心导管检查的患者。14例患者被诊断为房性心律失常。测量包括QRS向量大小、P-R间期、空间QRS-T角和空间P-R角在内的心电图参数，并在有和没有房性心律失常的患者之间进行比较。
只有QRSvm能独立区分有无房性心律失常，多变量风险比为0.743（95%可信区间0.581至0.951）。
在Fontan手术患者中，QRSvm是房性心律失常唯一重要的独立预测因素。
