Vectorcardiographic predictors of ventricular arrhythmia inducibility in patients with tetralogy of Fallot

J Electrocardiol. 2015 Mar-Apr;48(2):141-4. doi: 10.1016/j.jelectrocard.2014.11.009. Epub 2014 Nov 15.

Abstract

Introduction: Vectorcardiography (VCG) may have predictive value in Tetralogy of Fallot (TOF) patients undergoing ventricular arrhythmia inducibility (VAI) electrophysiology studies (EPs).

Materials and methods: Blinded, retrospective analyses of 37 adult TOF patients undergoing EPs prior to pulmonary valve replacements were performed (21 female, median age 37years). VAI was evaluated from EPs and resting 12-lead electrocardiograms, respectively using QRS and heart rate adjusted Q-T intervals, spatial QRS-T angles (peaks), T-wave and QRS-wave (QRSwave vc) component vector root mean squares. Differences were assessed (Student t-tests, Mann Whitney U-tests, Analysis of Variance). Relative risks were calculated.

Results: 16 patients had VAI (6 monomorphic, 10 polymorphic). Only the QRSwave vc showed significant differences between those with and without VAI, 10.5±2.4 dmV vs. 13.9±4.5dmV, respectively (p=0.002), area under the ROC curve of 0.78 and relative risk of 2.52.

Conclusion: VCG evidence of depolarization differences was significant between TOF patients with and without inducible VA.

Keywords: Tetralogy of Fallot; Vectorcardiography; Ventricular tachycardia.

MeSH terms

  • Adult
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Humans
  • Male
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / physiopathology
  • Tetralogy of Fallot / complications*
  • Tetralogy of Fallot / physiopathology
  • Vectorcardiography*