Lower spatial QRS-T angle rules out sustained ventricular arrhythmias in children with hypertrophic cardiomyopathy

Daniel Cortez, Nandita Sharma, Jean Cavanaugh, Froilan Tuozo, Gwendolyn Derk, Emily Lundberg, Keith Weiner, Nafiz Kiciman, Juan Alejos, Bruce Landeck, Jamil Aboulhosn, Shelley Miyamoto, Anthony C. McCanta, Anjan S. Batra

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction The spatial peaks QRS-T angle accurately distinguishes children with hypertrophic cardiomyopathy from their healthy counterparts. The spatial peaks QRS-T angle is also useful in risk stratification for ventricular arrhythmias. We hypothesised that the spatial peaks QRS-T angle would be useful for the prediction of ventricular arrhythmias in hypertrophic cardiomyopathy patients under 23 years of age. Methods Corrected QT interval and spatial peaks QRS-T angles were retrospectively assessed in 133 paediatric hypertrophic cardiomyopathy patients (12.4±6.6 years) with versus without ventricular arrhythmias of 30 seconds or longer. Significance, positive/negative predictive values, and odds ratios were calculated based on receiver operating characteristic curve cut-off values. Results In total, 10 patients with ventricular arrhythmias were identified. Although the corrected QT interval did not differentiate those with versus without ventricular arrhythmias, the spatial peaks QRS-T angle did (151.4±19.0 versus 116.8±42.6 degrees, respectively, p<0.001). At an optimal cut-off value (124.1 degrees), the positive and negative predictive values of the spatial peaks QRS-T angle were 15.4 and 100.0%, respectively, with an odds ratio of 25.9 (95% CI 1.5-452.2). Conclusion In children with hypertrophic cardiomyopathy, the spatial peaks QRS-T angle is associated with ventricular arrhythmia burden with high negative predictive value and odds ratio.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalCardiology in the young
Volume27
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

  • QTc
  • Spatial QRS-T angle
  • hypertrophic cardiomyopathy
  • prediction
  • ventricular arrhythmias

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