"QT Clock" to Improve Detection of QT Prolongation in Long QT Syndrome Patients

Overview

Journal Heart Rhythm

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2015 Sep 4

PMID 26334569

Citations 12

Authors

Alex Page

Mehmet K Aktas

Tolga Soyata

Wojciech Zareba

Jean-Philippe Couderc

Affiliations

Soon will be listed here.

Abstract

Background: The QT interval is a risk marker for cardiac events such as torsades de pointes. However, QT measurements obtained from a 12-lead ECG during clinic hours may not capture the full extent of a patient's daily QT range.

Objective: The purpose of this study was to evaluate the utility of 24-hour Holter ECG recording in patients with long QT syndrome (LQTS) to identify dynamic changes in the heart rate-corrected QT interval and to investigate methods of visualizing the resulting datasets.

Methods: Beat-to-beat QTc (Bazett) intervals were automatically measured across 24-hour Holter recordings from 202 LQTS type 1, 89 type 2, and 14 type 3 genotyped patients and a reference group of 200 healthy individuals. We measured the percentage of beats with QTc greater than the gender-specific threshold (QTc ≥470 ms in women and QTc ≥450 ms in men). The percentage of beats with QTc prolongation was determined across the 24-hour recordings.

Results: Based on the median percentage of heartbeats per patient with QTc prolongation, LQTS type 1 patients showed more frequent QTc prolongation during the day (~3 PM) than they did at night (~3 AM): 97% vs 48%, P ~10(-4) for men, and 68% vs 30%, P ~10(-5) for women. LQTS type 2 patients showed less frequent QTc prolongation during the day compared to nighttime: 87% vs 100%, P ~10(-4) for men, and 62% vs 100%, P ~10(-3) for women.

Conclusion: In patients with genotype-positive LQTS, significant differences exist in the degree of daytime and nocturnal QTc prolongation. Holter monitoring using the "QT clock" concept may provide an easy, fast, and accurate method for assessing the true personalized burden of QTc prolongation.

Citing Articles

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Clinical and functional characterisation of a recurrent KCNQ1 variant in the Belgian population.

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Holter Recordings at Initial Assessment for Long QT Syndrome: Relationship to Genotype Status and Cardiac Events.

Waddell-Smith K, Chaptynova A, Li J, Crawford J, Hinds H, Skinner J J Cardiovasc Dev Dis. 2022; 9(5).

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Skin Sympathetic Nerve Activity and the Short-Term QT Interval Variability in Patients With Electrical Storm.

Chen S, Meng G, Doytchinova A, Wong J, Straka S, Lacy J Front Physiol. 2022; 12:742844.

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Long QT syndrome with potassium voltage-gated channel subfamily H member 2 gene mutation mimicking refractory epilepsy: case report.

Kang H, Lan L, Jia Y, Li C, Fang Y, Zhu S BMC Neurol. 2021; 21(1):338.

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