Key result
A widened frontal QRS-T angle was significantly associated with frequent premature ventricular contractions, with an angle of ≥34° predicting high PVC burden with 82.2% sensitivity (AUC 0.887).
Why the study?
Frequent premature ventricular contractions can cause impaired ventricular function, and the study investigated whether the frontal plane QRS-T angle predicts premature ventricular contraction burden in ambulatory 24-hour Holter.
Does frontal QRS-T angle predict premature ventricular contraction burden in patients undergoing 24-hour Holter monitoring?
Observational (n=100)
No
Does frontal QRS-T angle predict premature ventricular contraction burden in patients undergoing 24-hour Holter monitoring?
Absolute Event Rate: 63.34% vs 23.46%
p-value: p=<0.001
A widened frontal QRS-T angle on a standard 12-lead ECG can serve as a simple, non-invasive surrogate marker to predict increased premature ventricular contraction burden.
Aim: Frequent premature ventricular contractions (PVCs) can cause impaired ventricular function or dilatation of ventricular cavities. The frontal plane QRS-T [f(QRS-T)] angle is an indicator of instability in the electrophysiological properties of the myocardium and is associated with arrhythmias. The present study aimed to investigate whether f(QRS-T) angle, as a marker of ventricular repolarization heterogeneity, predicts premature ventricular contraction burden in ambulatory 24-hour Holter.Methods: The study included 100 patients. The patients were divided into two groups as ‘frequent PVC’ and ‘seldom PVC’ according to their PVC burden in 24-hour Holter monitoring. Laboratory and some ambulatory electrocardiography parameters, including frontal plane QRS-T angle, were compared between the two groups.Results: Frontal QRS-T angle (63.34±37.86° vs 23.46±14.29° p<0.001) was found to be wider in the Frequent PVC group. F(QRS-T) angle of ≥ 34° had a sensitivity of 82.2% and a specificity of 80% in indicating PVC load (AUC: 0.887 (0.824-0.950). In addition, a positive correlation was found between PVC burden and f(QRS-T) angle (r:0.429 p<0.001).Conclusion: The widening of f(QRS-T) angle could perhaps be considered as a surrogate marker of increased PVC burden in 24-hour Holter monitoring. Measuring f(QRS-T) angle in 12-lead ECG in patients with PVC may be a warning sign for increased PVC burden.
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Kuş et al. (2022) conducted an observational in Premature ventricular contractions (n=100). Frequent premature ventricular contractions (>10% burden) vs. Seldom premature ventricular contractions (<10% burden) was evaluated on Frontal QRS-T angle (p=<0.001). A widened frontal QRS-T angle was significantly associated with frequent premature ventricular contractions, with an angle of ≥34° predicting high PVC burden with 82.2% sensitivity (AUC 0.887).
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