scholarly journals Electrocardiographic intervals associated with incident atrial fibrillation: Dissecting the QT interval

Heart Rhythm ◽  
2017 ◽  
Vol 14 (5) ◽  
pp. 654-660 ◽  
Author(s):  
Jason D. Roberts ◽  
Elsayed Z. Soliman ◽  
Alvaro Alonso ◽  
Eric Vittinghoff ◽  
Lin Y. Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval ◽  
Electrocardiographic Intervals

Changes of QT interval in the acute phase after pulmonary vein isolation for paroxysmal atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Chikata ◽  
T Kato ◽  
K Ududa ◽  
S Fujita ◽  
K Otowa ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Female Patient ◽  
Pulmonary Vein Isolation ◽  
Acute Phase ◽  
Paroxysmal Atrial Fibrillation ◽  
Qt Interval ◽  
Qt Prolongation ◽  
Qtc Interval ◽  
The Impact

Abstract Introduction Pulmonary vein isolation (PVI) affects ganglionated plexi (GP) around the atrium, leading to a modification of the intrinsic cardiac autonomic system (ANS). In animal models, GP ablation has a potential risk of QT prolongation and ventricular arrhythmias. However, the impact of PVI on QT intervals in humans remains unclear. Purpose This study aims to evaluate the Impact of PVI on QT interval in patients with paroxysmal atrial fibrillation. Methods We analyzed consecutive 117 PAF patients for their first PVI procedures. 12-lead ECG was evaluated at baseline, 4 hr, day 1, 1 month, and 3 months after ablation. Only patients with sinus rhythm on 12-lead ECG at each evaluation point without antiarrhythmic drugs were included. Results Heart rate significantly increased at 4 hr, day 1, and 1 month. Raw QT interval prolonged at 4 hr (417.1±41.6 ms, P<0.001) but shortened at day 1 (376.4±34.1 ms, P<0.001), 1 month (382.2±31.5 ms, P<0.001), and 3 months (385.1±32.8 ms, P<0.001) compared to baseline (391.6±31.4 ms). Bazett- and Fridericia- corrected QTc intervals significantly prolonged at 4hr (Bazett: 430.8±27.9 ms, P<0.001; Fridericia: 425.8±27.4 ms, P<0.001), day1 (Bazett: 434.8±22.3 ms, P<0.001; Fridericia: 414.1±23.7 ms, P<0.001), 1M (Bazett: 434.8±22.3 ms, P<0.001; Fridericia: 408.2±21.0 ms, P<0.05), and 3M (Bazett: 420.1±21.8 ms, P<0.001; Fridericia: 407.8±21.1 ms, P<0.05) compared to baseline (Bazett: 404.9±25.2 ms; Fridericia: 400.0±22.6 ms). On the other hand, Framingham- and Hodges- corrected QTc interval significantly prolonged only at 4hr (Framingham: 424.1±26.6 ms, P<0.001; Hodges: 426.8±28.4 ms, P<0.001) and at day1 (Framingham: 412.3±29.3 ms, P<0.01; Hodges: 410.6±40.2 ms, P<0.05) compared to baseline (Framingham: 399.2±22.7 ms; Hodges: 400.7±22.8 ms). At 4 hr after ablation, raw QT and QTc of all formulas significantly prolonged than baseline. Raw QT and QTc prolongation at 4hr after ablation were more frequently observed in female patients. Multiple regression analysis revealed that female patient is a significant predictor of raw QT and QTc interval prolongation of all formulas 4hr after PVI. Conclusions Raw QT and QTc prolonged after PVI, especially in the acute phase. Female patient is a risk factor for QT prolongation in the acute phase after PVI. Funding Acknowledgement Type of funding source: None

scholarly journals The QT interval and risk of incident atrial fibrillation

Heart Rhythm ◽  
2013 ◽  
Vol 10 (10) ◽  
pp. 1562-1568 ◽  
Author(s):  
Mala C. Mandyam ◽  
Elsayed Z. Soliman ◽  
Alvaro Alonso ◽  
Thomas A. Dewland ◽  
Susan R. Heckbert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval

scholarly journals The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Simon W. Rabkin ◽  
Jacky K. K. Tang
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Flutter ◽  
Qt Interval ◽  
Atrial Arrhythmias ◽  
Exclusion Criteria ◽  
Bundle Branch Block ◽  
Qt Intervals ◽  
Ecg Database ◽  
Age And Sex ◽  
Important Marker

A short QT interval has been difficult to define, and there is debate whether it exists outside of an extremely small group of individuals with inherited channelopathies and whether it predicts cardiac arrhythmias. The objective was to identify cases with short QT and their consequences. Our hospital ECG database was screened for cases with a QTc based on the Bazett formula (QTcBZT) of less than 340 ms. The QTc was recalculated using the spline (QTcRBK) formula, which more accurately adjusts for the heart rate and identifies cases based on percentile distribution of the QT interval. The exclusion criteria were presence of bundle branch block, arrhythmias, or electronic pacemakers. An age- and sex-matched cohort was obtained from individuals with normal QT intervals with the same exclusion criteria. There were 28 cases with a short QTc (QTcRBK < 380 ms). The age was 69.6 ± 14.6 years (mean ± SD) (50% males). The QT interval was 305.7 ± 61.1 ms with QTcRBK 308.4 ± 31.4 ms. Subsequent ECGs showed atrial flutter in 21%, atrial fibrillation in 18%, and atrial tachycardia in 4% of cases. Thus, atrial arrhythmias occurred in 43% of cases. This incidence was significantly ( p < 0.0001 ) greater than the incidence of atrial arrhythmias in age- and sex-matched controls. In conclusion, a short QT interval can be readily identified based on the first percentile of the new QTc formula. A short QTc is an important marker for the development of atrial arrhythmias, including atrial flutter and atrial fibrillation, with the former predominating. It should be part of patient assessment and warrants consideration to develop strategies for detection and prevention of atrial arrhythmias.

scholarly journals Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Part 2: Assessment of Safety

2019 ◽  
Vol 14 (6) ◽  
pp. 826-830
Author(s):  
N. Yu. Mironov ◽  
V. V. Vlodzyanovskiy ◽  
Yu. A. Yuricheva ◽  
S. F. Sokolov ◽  
S. P. Golitsyn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval ◽  
Persistent Atrial Fibrillation ◽  
Initial Assessment ◽  
Class Iii ◽  
Qt Interval Prolongation ◽  
Direct Current Cardioversion ◽  
Group 2 ◽  
Pharmacological Cardioversion ◽  
Ischemic Attack

Aim. To compare safety of new class III antiarrhythmic drug Refralon with direct current cardioversion (DCC) in patients with persistent atrial fibrillation (AF). Material and methods. 60 patients with persistent AF were randomized to groups of DCC (n=30) and pharmacologic conversion (PCV; n=30). There were no significant differences in age, sex, AF duration, concomitant cardiovascular diseases, CHA2DS2-VASc score and echocardiographic parameters between the groups compared. Initial assessment excluded contraindications to restore sinus rhythm (SR). In DCC group two attempts using biphasic synchronized shocks of 150 J and 170 J were performed. In PCV group patients received up to three subsequent intravenous injections of Refralon 10 μg/kg (maximal dose 30 μg/kg). Results. There were no mortality, stroke, transient ischemic attack, ventricular arrhythmia, asystole longer than 3,0 sec (primary safety criteria) in both groups. Prolongation of QT interval longer than 500 ms observed in 1 of 30 patients (3,3%) in DCC group and in 7 of 30 patients (23,3%) in PCV group. 2 patients (one patient in each group; 3,3%) developed asymptomatic bradycardia after conversion to SR that resolved spontaneously within 30 minutes. 95% confidence interval (95%CI) for secondary safety criteria is [0,02-0,38] for QT prolongation and [-0,04-0,04] for bradycardia. Conclusion. Safety of PCV is noninferior to DCC in patients with persistent AF in terms of primary safety criteria and bradyarrhythmias. More frequent QT interval prolongation to values >500 ms observed in PCV group points to necessity of precautions with use of the drug.

scholarly journals Recent heart rate history affects QT interval duration in atrial fibrillation

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0172962 ◽  
Author(s):  
Fady S. Riad ◽  
Eathar Razak ◽  
Samir Saba ◽  
Alaa Shalaby ◽  
Jan Nemec
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Qt Interval ◽  
Interval Duration ◽  
Qt Interval Duration

scholarly journals Measurements of blood pressure and electrocardiogram in conscious freely moving guineapigs: a model for screening QT interval prolongation effects

2007 ◽  
Vol 41 (4) ◽  
pp. 470-480 ◽  
Author(s):  
P Hess ◽  
M Rey ◽  
D Wanner ◽  
B Steiner ◽  
M Clozel
Keyword(s):  
Blood Pressure ◽  
Qt Interval ◽  
Abdominal Cavity ◽  
Good Alternative ◽  
Suitable Model ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Freely Moving ◽  
Electrocardiographic Intervals

The pro-arrhythmic risk inherent to a new drug must be assessed at an early preclinical stage. Telemetry system implantation is a method widely used in vivo in various species. The present study was designed to assess whether conscious freely moving guineapigs can be used to predict QT prolongation in vivo. The guineapig has three advantages over the dog and the primate. First, it has specific ion channels similar to man; second, a smaller amount of test article is required for the investigation and third, its housing is less expensive. Under sterile conditions and isoflurane anaesthesia, telemetry transmitters were implanted intraperitoneally in male Dunkin Hartley guineapigs. Blood pressure, heart rate and electrocardiographic intervals were measured from two days up to eight months. Chronic implantation of the telemetry device did not lead to anatomic or macroscopic alterations in the abdominal cavity and no inflammation of the peritoneum or infection was observed. Four reference compounds were used: three positive (sotalol, terfenadine and dofetilide) and one negative reference (enalapril). Single oral administration of all three positive references dose-dependently induced bradycardia and QT corrected (QTc) prolongation. In contrast, neither enalapril nor its vehicle prolonged the QTc. These results demonstrate that the guineapig is both a suitable model and a good alternative to dogs or primates to assess the potential of compounds for QT interval prolongation in the early stages of drug development.

scholarly journals The QT interval in atrial fibrillation.

Heart ◽  
1989 ◽  
Vol 61 (6) ◽  
pp. 510-513 ◽  
Author(s):  
G R Pai ◽  
J M Rawles
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval

scholarly journals Usefulness of electrocardiography in the differential diagnosis of dyspnoea

2015 ◽  
Vol 5 (2S) ◽  
pp. 21-25
Author(s):  
Flavio Cerrato ◽  
Angelo Bosio ◽  
Claudio Pascale
Keyword(s):  
Atrial Fibrillation ◽  
Qt Interval ◽  
Torsade De Pointes ◽  
Rhythm Control ◽  
Prolonged Qt Interval ◽  
Prolonged Qt ◽  
Pharmacological Cardioversion ◽  
Onset Atrial Fibrillation ◽  
New Onset ◽  
Severe Dyspnoea

We report a case of a 88-year-old female, admitted to the hospital with tachycardia, chest pain and dyspnoea. ECG revelead a recent new-onset atrial fibrillation. A pharmacological cardioversion with amiodarone was performed, and restoration of sinus rhythm was obtained. Sotalol for rhythm control was administered. On the eighth day after the admission, she presented with severe dyspnoea and hypotension. An ECG revelead torsade de pointes, associated with prolonged QT interval. Several factors are involved in determining dyspnoea. ECG, although not specific, is an important instrument that supports clinicians in assessment of dyspnoea.

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