QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy

Patel, Salma; Ackerman, Michael J.; Shamoun, Fadi; Ommen, Steve R.; Love, William T.; Stephen, S.; Bos, J. Martijn; Lester, Steven J.

doi:10.1080/00015385.2018.1440905

Cited by 29 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several mechanisms have been proposed to explain these observations, including concomitant atrial cardiomyopathy, atrial torsades de pointes, atrio‐ventricular dyssynchrony secondary to QTc prolongation, and inflammatory reaction in both the atria and ventricles . Interestingly, in a series of over 1600 HCM patients from the Mayo Clinic, the authors found that the cut‐off value of QTc that could significantly predict death or SCD was 450 ms, almost identical to the value we calculated for predicting AF ablation outcome in HCM patients …”

Section: Discussionsupporting

confidence: 68%

See 1 more Smart Citation

Depolarization and repolarization parameters on ECG predict recurrence after atrial fibrillation ablation in patients with hypertrophic cardiomyopathy

Wen

Zhu

Sun

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction The outcomes of atrial fibrillation (AF) ablation remain suboptimal. It is important to identify which AF patients will most likely benefit from ablation and who are more likely to show treatment failure, especially in those with structural heart disease such as hypertrophic cardiomyopathy (HCM). Methods and Results We enrolled 120 HCM patients who underwent primary AF ablation (48 with persistent AF). Preprocedural QTc was measured and corrected using the Bazett's formula, and the distribution of fragmentation of the QRS complex (fQRS) was recorded. Arrhythmia recurrence was defined as any kind of documented atrial tachyarrhythmia of more than 30 seconds. Overall, arrhythmia recurrence occurred in 69 patients after 13.4 months’ follow‐up. fQRS was present in 71 (59.17%) patients and was most commonly (81.69%) observed in the inferior leads. QTc more than 448 ms could predict arrhythmia recurrence with a sensitivity of 68.1% and specificity of 68.6%. Patients with QTc more than 448 ms (hazard ratio [HR]: 1.982; 95% confidence interval [CI]: 1.155‐3.402; P = .013) or those with fQRS+ (HR: 1.922; 95% CI: 1.151‐3.210; P = .012) were at an increased risk of recurrence. A combination of fQRS+ and QTc more than 448 ms was superior to fQRS or QTc alone in predicting arrhythmia recurrence. Conclusion In patients with HCM undergoing AF ablation, QTc prolongation, specifically >448 ms, and presence of fQRS are independent risk factors for arrhythmia recurrence at follow‐up. The combination of these two parameters has greater predictive value and would help to identify patients who are at the highest risk of procedural failure.

show abstract

Section: Discussionsupporting

confidence: 68%

“…10,16 Interestingly, in a series of over 1600 HCM patients from the Mayo Clinic, the authors found that the cut-off value of QTc that could significantly predict death or SCD was 450 ms, almost identical to the value we calculated for predicting AF ablation outcome in HCM patients. 17…”

Section: Qtc Interval Prolongation and Arrhythmia Recurrencementioning

confidence: 99%

Depolarization and repolarization parameters on ECG predict recurrence after atrial fibrillation ablation in patients with hypertrophic cardiomyopathy

Wen

Zhu

Sun

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…T waves can be helpful in a variety of pathologies: as an example, tall T waves in anterior chest lead III, aVR, and V1 with a negative QRS complex may suggest acute myocardial ischemia 10 . QT interval measures myocardial depolarization and repolarization time, while shortening or prolongation of QT interval is associated with an increased risk for arrhythmias and sudden cardiac death (SCD) 11,12 . Abnormal PR interval is a risk factor for atrial fibrillation and heart block 13 .…”

mentioning

confidence: 99%

A genome-wide association and polygenic risk score study on abnormal electrocardiogram in a Chinese population

Wang

Gao

Shi

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Electrocardiography is a common and widely-performed medical examination based on the measurement and evaluation of electrocardiogram (ECG) to assess the up-to-date cardiac rhythms and thus suggest the health conditions of cardiovascular system and on a larger level the individual’s wellness. Abnormal ECG assessment from the detection of abnormal heart rhythms may have clinical implications including blood clots in formation, ongoing heart attack, coronary artery blockage, etc. Past genetic-phenotypic research focused primarily on the physical parameters of ECG but not the medical evaluation. To unbiasedly uncover the underlying links of genetic variants with normal vs. abnormal ECG assessment, a genome-wide association study (GWAS) is carried out in a 1006-participant cohort of Chinese population effectively genotyped for 243487 single nucleotide polymorphisms (SNPs). Both age and sex are influential factors, and six novel SNPs are identified for potential association with abnormal ECG. With the selected SNPs, a polygenic risk score (PRS) differentiates the case–control subgroups, and correlates well with increased risk of abnormal ECG. The findings are reproduced in an independent validation cohort. The derived PRS may function as a potential biomarker for prospectively screening the high-risk subgroup of heart issues in the Chinese population.

show abstract

“…SCD from the former is partly accounted for by the increase in fluid, electrolytes, and metabolites, while that from the latter may represent intradialytic risk of arrhythmia and the potential for subsequent fatal event during and immediately after a dialysis session. Recent reports showing the strong relationship between QTc interval and SCD in hypertrophic cardiomyopathy [18, 19] and the impact on QTc interval of vascular calcification which becomes more severe as the stage of CKD progresses [20], allowed us to believe the importance of QTc interval as risk assessment for SCD in HD patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in QTc interval in long-term hemodialysis patients

Matsumoto

Mori

Kageyama³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

BackgroundCardiovascular diseases, including sudden cardiac death (SCD), are the leading cause of death in hemodialysis (HD) patients. A prolonged QT interval on the electrocardiogram (ECG) is a risk factor for SCD in HD patients. This study investigated whether the heart rate-corrected QT (QTc) interval becomes prolonged along with dialysis vintage.MethodsA total of 102 HD patients were retrospectively studied. Their ECG data were analyzed at 1, 4, and 7 years after HD initiation. The control group comprised 68 age-matched individuals who had normal renal function and two available ECG reports at an interval of more than 4 years. QTc was measured according to the Bazett formula. The association between QTc interval and dialysis vintage was studied. Additionally, clinically relevant variables related to QTc duration at 1 year after HD initiation were assessed.ResultsAverage QTc interval at 4 and 7 years after HD initiation was significantly longer than that at 1 year after HD initiation (443, 445, and 437 ms) (p<0.05). On the other hand, QTc interval in the control group was 425 ms in the first year and 426 ms after an average of 6 years. They had no significant differences, although they were much shorter than that in HD patients. Multivariate regression analysis of baseline variables revealed that the corrected calcium levels (p = 0.041) and diabetes (p = 0.043) were independently associated with longer QTc interval.ConclusionsThe QTc interval at 1 year after HD initiation was longer than in the control subjects and was prolonged over several years of HD treatment. Providing clinical management with a focus on QTc interval may be helpful for reducing the incidence of SCD in HD patients.

show abstract

QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy

Abstract: Prolonged QTc was a risk factor for SCD and death even when controlling for typical risk factors.

Cited by 29 publications

References 14 publications

Depolarization and repolarization parameters on ECG predict recurrence after atrial fibrillation ablation in patients with hypertrophic cardiomyopathy

Depolarization and repolarization parameters on ECG predict recurrence after atrial fibrillation ablation in patients with hypertrophic cardiomyopathy

A genome-wide association and polygenic risk score study on abnormal electrocardiogram in a Chinese population

Changes in QTc interval in long-term hemodialysis patients

Contact Info

Product

Resources

About