Frontal QRS-T Açısı İle Ambulatuar 24 Saat Holterde Prematür Ventriküler Kontraksiyon Yükü Arasındaki İlişki

Amaç: Sık prematür ventriküler kontraksiyonlar (PVK), ventriküler fonksiyonun bozulmasına veya ventriküler kavitelerin genişlemesine neden olabilir. Frontal düzlem QRS-T [f(QRS-T)] açısı, miyokardın elektrofizyolojik özelliklerindeki kararsızlığın bir göstergesidir ve aritmilerle ilişkilidir. Bu çalışma, ventriküler repolarizasyon heterojenitesinin bir belirteci olarak f(QRS-T) açısının, ambulatuar 24 saatlik holterde prematüre ventriküler kasılma yükünü tahmin edip etmediğini araştırmayı amaçlamıştır.Yöntem: Çalışmada 100 hasta mevcuttu. Hastalar 24 saatlik Holter izleminde PVK yüklerine göre “sık PVK” ve “nadir PVK” olarak iki gruba ayrıldı. Laboratuar ve frontal plan QRS-T açısı dahil olmak üzere bazı ambulatuar elektrokardiyografi parametreleri iki grup arasında karşılaştırıldı.Bulgular: Frontal QRS-T açısı (63.34±37.86°’ye karşı 23.46±14.29° p<0.001) Sık PVK grubunda daha geniş bulundu. F(QRS-T) açısının ≥ 34° olması; PVK yükünü göstermede %82.2 duyarlılığa ve %80 özgüllüğe sahipti (AUC: 0.887 (0.824-0.950). Ayrıca PVK yükü ile f(QRS-T) açısı arasında pozitif korelasyon bulundu (r:0.429 p<0.001).Sonuç: F(QRS-T) açısının genişlemesi, 24 saatlik Holter izleminde artmış PVK yükünün bir göstergesi olarak düşünülebilir. 12 derivasyonlu EKG'de PVK’sı olan hastalarda f(QRS-T) açısının ölçülmesi, artmış PVK yükü için uyarıcı bir bulgu olabilir.

Anahtar Kelimeler:

prematür ventriküler kontraksiyon, elektrokardiyografi, frontal QRS-T açısı

The relationship between frontal QRS-T angle and premature ventricular contraction burden in ambulatory 24-hour Holter

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.

Keywords:

premature ventricular contraction, electrocardiography, frontal QRS-T angle,

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