The Shortage of Short QT Intervals

Reinig, Michael; Engel, Toby R.

doi:10.1378/chest.06-2133

Cited by 28 publications

(14 citation statements)

References 16 publications

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“…Although prevalence studies have been conducted among European and Asian adult cohorts, [8][9][10][11]14 the literature lacks large-scale prevalence studies involving pediatric patients. To our knowledge, this is the largest cohort of pediatric patients with short QT interval in the literature.…”

Section: Discussionmentioning

confidence: 99%

Short QT Interval Prevalence and Clinical Outcomes in a Pediatric Population

Guerrier

Kwiatkowski

Czosek

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-Risk associated with short QT interval has recently received recognition. European studies suggest a prevalence of 0.02% to 0.1% in the adult population, but similar studies in pediatric patients are limited. We sought to determine the prevalence of short QT interval in a pediatric population and associated clinical characteristics and outcomes. Methods and Results-Retrospective review of an ECG database at a single pediatric institution. The database was queried for ECGs on patients ≤21 years with electronically measured QTc of 140 to 340 ms. Patients with QTc of 140 to 340 ms confirmed by a pediatric electrophysiologist were identified for chart review for associated clinical characteristics, symptoms, and outcome. Patients with and without symptoms were compared in an attempt to identify variables associated with outcome. The query included 272 504 ECGs on 99 380 unique patients. Forty-five patients (35 men, 76%) had QTc ≤340 ms, for a prevalence of 0.05%. Median age was 15 years (interquartile range, 2-17), median QT 330 ms (interquartile range, 280-360), and median QTc 323 ms (IQR,(313)(314)(315)(316)(317)(318)(319)(320)(321)(322)(323)(324)(325)(326)(327)(328)(329)(330)(331)(332). Women had significantly shorter QTc compared with men (312 versus 323 ms; P=0.03). Two deaths were noted in chart review-one from respiratory failure and the second of unknown pathogenesis in a patient with dilated cardiomyopathy. Conclusions-Short QT interval was a rare finding in this pediatric population, with a prevalence of 0.05%. Male predominance was identified, although the median QT interval was significantly shorter in women. There seem to be no unifying clinical characteristics for this pediatric patient cohort with short QT interval. (Circ Arrhythm Electrophysiol.

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Section: Discussionmentioning

confidence: 99%

Short QT Interval Prevalence and Clinical Outcomes in a Pediatric Population

Guerrier

Kwiatkowski

Czosek

et al. 2015

Circ: Arrhythmia and Electrophysiology

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“…4,30–34 Normal values for QTc range from 350 to 450 ms for adult men, and 360 to 460 ms for adult women. 4,30,32,35–36 but up to 10–20% of otherwise healthy persons may have QTc values outside of this range.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic QT Interval and Mortality

et al. 2011

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Background Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population are still unclear. Methods We performed a meta-analysis to investigate the relation of QT interval with mortality endpoints. Inverse-variance weighted random-effects models were used to summarize the relative risks across studies. Twenty-three observational studies were included. Results The pooled relative risk estimates comparing the highest with the lowest categories of QT-interval length were 1.35 (95% confidence interval = 1.24–1.46) for total mortality, 1.51 (1.29–1.78) for cardiovascular mortality, 1.71 (1.36–2.15) for coronary heart disease mortality, and 1.44 (1.01–2.04) for sudden cardiac death. A 50 msec increase in QT interval was associated with a relative risk of 1.20 (1.15–1.26) for total mortality, 1.29 (1.15–1.46) for cardiovascular mortality, 1.49 (1.25–1.76) for coronary heart disease mortality, and 1.24 (0.97–1.60) for sudden cardiac death. Conclusions We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population.

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“…In the large Finnish population study, a QT c value Ͻ340 ms was observed in 0.4% of the population, whereas a QT c value Ͻ320 ms was found in just 0.1% (6). This low frequency of extremely short QT intervals was further corroborated by multiple additional studies that demonstrated similar findings (7)(8)(9)11,39). Accordingly, patients with a QT c value less than 350 ms receive 2 points, whereas 3 points are assigned for a QT c value Ͻ330 ms. Of note, patients should not receive points in the presence of modifiable factors known to abbreviate the QT interval such as hypercalcemia, digoxin administration, and androgen use (40 -42).…”

Section: Figure 1 Cellular Mechanism Of Short Qt Intervalmentioning

confidence: 83%