Özen Kaya, Karahan Mehmet Zülkif
Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, TUR.
Cardiology, Mardin Artuklu University Faculty of Medicine, Mardin, TUR.
Cureus. 2023 Jan 9;15(1):e33541. doi: 10.7759/cureus.33541. eCollection 2023 Jan.
Maintaining sinus rhythm is important in the management of atrial fibrillation (AF). After cardioversion, there is a significant probability of AF recurrence. There is limited research on the relationship between AF recurrence and ECG parameters. This study aimed to evaluate whether the frontal plane QRS-T angle (fQRS-T), a predictor of ventricular heterogeneity, could be used to predict AF recurrence following cardioversion.
The study was conducted as a retrospective observational study. Patients diagnosed with acute-onset AF for the first time were included in the study. All patients underwent an ECG after cardioversion, and ECG parameters were evaluated. The patients were separated into two groups based on the presence of AF recurrence during hospitalization after cardioversion. The relationship between the fQRS-T and AF recurrence was also examined.
A total of 162 patients, comprising 68 women (41.9%) and 94 men (58.1%) with an average age of 59.4±6.5 years, were enrolled in the research. Based on the patient monitoring device findings, patients were separated into two groups: non-recurrent AF (n=118) and recurrent AF (n=44). P-wave duration was significantly longer in the recurrence group (p=0.009). The recurrence group's mean fQRS-T was significantly higher (p<0.001). AF recurrence was substantially higher in patients with fQRS-T >90 ° compared to those with fQRS-T ≤90 ° (56.1% vs. 14.2%, p <0.001). Increased fQRS-T>93.7 ° indicated AF recurrence with 78.3% sensitivity and 83.4% specificity (AUC {area under curve}:0.748, p < 0.001). In multivariate analysis, fQRS-T was revealed to be an early indicator of recurrent AF (OR: 1.882, 95%CI: 1.358-2.881, p<0.001).
The fQRS-T, an easily determinable parameter from automatic identification ECG recordings, may be useful for predicting the early return of AF after successful cardioversion.
维持窦性心律在房颤（AF）管理中至关重要。复律后，房颤复发的可能性很大。关于房颤复发与心电图参数之间关系的研究有限。本研究旨在评估额面QRS-T角（fQRS-T）这一心室异质性的预测指标是否可用于预测复律后房颤复发。
本研究为回顾性观察研究。纳入首次诊断为急性发作房颤的患者。所有患者复律后均接受心电图检查，并评估心电图参数。根据复律后住院期间房颤复发情况将患者分为两组。还检查了fQRS-T与房颤复发之间的关系。
共有162例患者纳入研究，其中68例女性（41.9%），94例男性（58.1%），平均年龄59.4±6.5岁。根据患者监测设备的结果，患者分为两组：非复发性房颤组（n = 118）和复发性房颤组（n = 44）。复发组的P波时限明显更长（p = 0.009）。复发组的平均fQRS-T明显更高（p < 0.001）。fQRS-T>90°的患者房颤复发率明显高于fQRS-T≤90°的患者（56.1%对14.2%，p < 0.001）。fQRS-T>93.7°提示房颤复发，敏感性为78.3%，特异性为83.4%（曲线下面积{AUC}：0.748，p < 0.001）。多因素分析显示，fQRS-T是房颤复发的早期指标（OR：1.882，95%CI：1.358 - 2.881，p < 0.001）。
fQRS-T是一个可从自动识别心电图记录中轻松确定的参数，可能有助于预测成功复律后房颤的早期复发。
