Pediatric Cardiology

, Volume 38, Issue 5, pp 1049–1056 | Cite as

Clinical Application of the QRS-T Angle for the Prediction of Ventricular Arrhythmias in Patients with the Fontan Palliation

Original Article


Fontan palliation patients are at risk for ventricular arrhythmias post-operatively. This study aimed to evaluate whether differences in the spatial QRS-T angle can reliably predict ventricular arrhythmias in patients who had undergone Fontan palliation. A total of 117 patients who had the Fontan palliation and post-Fontan catheterization were included. Ventricular arrhythmias were identified in nine patients. Measurements of ECG parameters including QRS vector magnitude, QRS duration, corrected QT interval, and spatial peaks QRS-T angles were performed, and compared between those with and without ventricular arrhythmias. The only ECG parameter to distinguish those with versus those without VA was the SPQRS-T angle (p < 0.001), which at a cut-off value of 102.9° gave sensitivity, specificity, positive and negative predictive values of 100.0, 57.0, 17.6 and 100.0%, respectively. Only the spatial peaks QRS-T angle differentiated those with and without ventricular arrhythmia development with a univariate HR 1.237 (95% CI 1.021–1.500) and a multivariate HR of 1.032 (1.009–1.056) when catheter measured parameters were taken into account. In Fontan patients, the spatial peaks QRS-T angle is a significant independent predictor of ventricular arrhythmias. Clinical usefulness of this parameter remains to be seen and should be tested prospectively.


Fontan Vectorcardiography Ventricular arrhythmias 



No funding was given for this study.

Compliance with Ethical Standards

Conflicts of interest

No conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies were in accordance with ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Supplementary material

246_2017_1618_MOESM1_ESM.docx (43 kb)
Supplementary material 1 (DOCX 43 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.University of Colorado School of MedicineAuroraUSA
  2. 2.Electrophysiology fellowPenn State Milton S. Hershey Medical CenterHersheyUSA
  3. 3.Clinical SciencesLund UniversityLundSweden

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