Circulation, Vol 83, 1888-1894, Copyright © 1991 by American Heart Association
A Algra, JG Tijssen, JR Roelandt, J Pool and J Lubsen
BACKGROUND. QTc prolongation has been implicated as a risk factor for
sudden death; however, a controversy exists over its significance. METHODS
AND RESULTS. In the Rotterdam QT Project, 6,693 consecutive patients who
underwent 24-hour ambulatory electrocardiography were followed up for 2
years; of these, 245 patients died suddenly. A standard 12-lead
electrocardiogram and clinical data at the time of 24- hour ambulatory
electrocardiography were collected for all patients who died suddenly and
for a random sample of 467 patients from the study cohort. In all patients
without an intraventricular conduction defect (176 patients who died
suddenly and 390 patients from the sample), QT interval duration was
measured in leads I, II, and III and corrected for heart rate with Bazett's
formula (QTc). In patients without evidence of cardiac dysfunction (history
of symptoms of pump failure or an ejection fraction less than 40%), QTc of
more than 440 msec was associated with a 2.3 times higher risk for sudden
death compared with a QTc of 440 msec or less (95% confidence interval:
1.4, 3.9). In contrast, in patients with evidence of cardiac dysfunction,
the relative risk of QTc prolongation was 1.0 (0.5, 1.9). Adjustment for
age, gender, history of myocardial infarction, heart rate, and the use of
drugs did not alter these relative risks. CONCLUSIONS. These data indicate
that in patients without intraventricular conduction defects and cardiac
dysfunction, QTc prolongation measured from the standard electrocardiogram
is a risk factor for sudden death independent of age, history of myocardial
infarction, heart rate, and drug use. In patients with cardiac dysfunction,
QTc duration is not related to the risk for sudden death.
ARTICLES
QTc prolongation measured by standard 12-lead electrocardiography is an independent risk factor for sudden death due to cardiac arrest
Department of Cardiology, Erasmus University Rotterdam, The Netherlands.
This article has been cited by other articles:
 |
|
 |
|
  A Verrotti, G Loiacono, A Mohn, and F Chiarelli New insights in diabetic autonomic neuropathy in children and adolescents Eur. J. Endocrinol., December 1, 2009; 161(6): 811 - 818. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Tikkanen, O. Anttonen, M. J. Junttila, A. L. Aro, T. Kerola, H. A. Rissanen, A. Reunanen, and H. V. Huikuri Long-Term Outcome Associated with Early Repolarization on Electrocardiography N. Engl. J. Med., November 16, 2009; (2009) NEJMoa0907589v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B. Petrov Starvation Diets as a Cause of Acquired Long QT Syndrome Ann Intern Med, April 7, 2009; 150(7): 501 - 501. [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Chugh, K. Reinier, T. Singh, A. Uy-Evanado, C. Socoteanu, D. Peters, R. Mariani, K. Gunson, and J. Jui Determinants of Prolonged QT Interval and Their Contribution to Sudden Death Risk in Coronary Artery Disease: The Oregon Sudden Unexpected Death Study Circulation, February 10, 2009; 119(5): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Genovesi, C. Dossi, M. R. Vigano, E. Galbiati, F. Prolo, A. Stella, and M. Stramba-Badiale Electrolyte concentration during haemodialysis and QT interval prolongation in uraemic patients Europace, June 1, 2008; 10(6): 771 - 777. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Severi, E. Grandi, C. Pes, F. Badiali, F. Grandi, and A. Santoro Calcium and potassium changes during haemodialysis alter ventricular repolarization duration: in vivo and in silico analysis Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1378 - 1386. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. B. Lehtinen, C. Newton-Cheh, J. T. Ziegler, C. D. Langefeld, B. I. Freedman, K. R. Daniel, D. M. Herrington, and D. W. Bowden Association of NOS1AP Genetic Variants With QT Interval Duration in Families From the Diabetes Heart Study Diabetes, April 1, 2008; 57(4): 1108 - 1114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Georgy, J. Neceskas, and S. Goodin Antiemetic care for patients with breast cancer: Focus on drug interactions and safety concerns Am. J. Health Syst. Pharm., November 1, 2007; 64(21): 2227 - 2236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Newton-Cheh, C.-Y. Guo, M. G. Larson, S. L. Musone, A. Surti, A. L. Camargo, J. A. Drake, E. J. Benjamin, D. Levy, R. B. D'Agostino Sr, et al. Common Genetic Variation in KCNH2 Is Associated With QT Interval Duration: The Framingham Heart Study Circulation, September 4, 2007; 116(10): 1128 - 1136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Fanoe, C. Hvidt, P. Ege, and G. B. Jensen Syncope and QT prolongation among patients treated with methadone for heroin dependence in the city of Copenhagen Heart, September 1, 2007; 93(9): 1051 - 1055. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Iacoviello, C. Forleo, P. Guida, R. Romito, A. Sorgente, S. Sorrentino, S. Catucci, F. Mastropasqua, and M. Pitzalis Ventricular Repolarization Dynamicity Provides Independent Prognostic Information Toward Major Arrhythmic Events in Patients With Idiopathic Dilated Cardiomyopathy J. Am. Coll. Cardiol., July 17, 2007; 50(3): 225 - 231. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Chrysohoou, D. B Panagiotakos, C. Pitsavos, J. Skoumas, X. Krinos, Y. Chloptsios, V. Nikolaou, and C. Stefanadis Long-term fish consumption is associated with protection against arrhythmia in healthy persons in a Mediterranean region--the ATTICA study Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1385 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Mozaffarian, R. J. Prineas, P. K. Stein, and D. S. Siscovick Dietary Fish and n-3 Fatty Acid Intake and Cardiac Electrocardiographic Parameters in Humans J. Am. Coll. Cardiol., August 1, 2006; 48(3): 478 - 484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M.J.M. Straus, J. A. Kors, M. L. De Bruin, C. S. van der Hooft, A. Hofman, J. Heeringa, J. W. Deckers, J. H. Kingma, M. C.J.M. Sturkenboom, B. H. Ch. Stricker, et al. Prolonged QTc Interval and Risk of Sudden Cardiac Death in a Population of Older Adults J. Am. Coll. Cardiol., January 17, 2006; 47(2): 362 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Schulman, P. R. Muskin, and P. A. Shapiro Psychiatry and Cardiovascular Disease Focus, April 1, 2005; 3(2): 208 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Aapro, C.-H. Kohne, H. J. Cohen, and M. Extermann Never Too Old? Age Should Not Be a Barrier to Enrollment in Cancer Clinical Trials Oncologist, March 1, 2005; 10(3): 198 - 204. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T.-M. Lee, M.-S. Lin, T.-F. Chou, and N.-C. Chang Effect of simvastatin on left ventricular mass in hypercholesterolemic rabbits Am J Physiol Heart Circ Physiol, March 1, 2005; 288(3): H1352 - H1358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Vanoli, S. Bacchini, S. Panigada, F. Pentimalli, and P. B Adamson Experimental models of heart failure Eur. Heart J. Suppl., November 1, 2004; 6(suppl_F): F7 - F15. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Montanez, J. N. Ruskin, P. R. Hebert, G. A. Lamas, and C. H. Hennekens Prolonged QTc Interval and Risks of Total and Cardiovascular Mortality and Sudden Death in the General Population: A Review and Qualitative Overview of the Prospective Cohort Studies Arch Intern Med, May 10, 2004; 164(9): 943 - 948. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Kumar, M. Fisher, and P. W Macfarlane Review: Diabetes and the QT interval: time for debate The British Journal of Diabetes & Vascular Disease, May 1, 2004; 4(3): 146 - 150. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Dekker, R. S. Crow, P. J. Hannan, E. G. Schouten, and A. R. Folsom Heart rate-corrected QT interval prolongation predicts risk of coronary heart disease in black and white middle-aged men and women: The ARIC study J. Am. Coll. Cardiol., February 18, 2004; 43(4): 565 - 571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Okin QT interval prolongation and prognosis: further validation of the quantitative approach to electrocardiography J. Am. Coll. Cardiol., February 18, 2004; 43(4): 572 - 575. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Algra, P. C. Gates, A. J. Fox, V. Hachinski, and H. J.M. Barnett Side of Brain Infarction and Long-Term Risk of Sudden Death in Patients With Symptomatic Carotid Disease Stroke, December 1, 2003; 34(12): 2871 - 2875. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Sarapa, M. R. Britto, B. Cotton, S. R. Cox, S. F. Francom, N. Jin, E. D. Polasek, S. M. Sainati, S. L. Crosby-Sessoms, and J. C. Fleishaker Valdecoxib, a COX-2-Specific Inhibitor, Does Not Affect Cardiac Repolarization J. Clin. Pharmacol., September 1, 2003; 43(9): 974 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Marfella, P. Gualdiero, M. Siniscalchi, C. Carusone, M. Verza, S. Marzano, K. Esposito, and D. Giugliano Morning Blood Pressure Peak, QT Intervals, and Sympathetic Activity in Hypertensive Patients Hypertension, February 1, 2003; 41(2): 237 - 243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Diedrich, J. Jordan, J. R. Shannon, D. Robertson, and I. Biaggioni Modulation of QT Interval During Autonomic Nervous System Blockade in Humans Circulation, October 22, 2002; 106(17): 2238 - 2243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Goodin and R. Cunningham 5-HT3-Receptor Antagonists for the Treatment of Nausea and Vomiting: A Reappraisal of Their Side-Effect Profile Oncologist, October 1, 2002; 7(5): 424 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, A.J. Camm, R. Cappato, S.M. Cobbe, C. Di Mario, et al. Task Force on Sudden Cardiac Death of the European Society of Cardiology Eur. Heart J., August 2, 2001; 22(16): 1374 - 1450. [PDF]
|
|
|
|
|
|
L Jordaens, R Tavernier, and MIRRACLE Investigators Determinants of sudden death after discharge from hospital for myocardial infarction in the thrombolytic era Eur. Heart J., July 2, 2001; 22(14): 1214 - 1225. [Abstract] [PDF]
|
|
|
|
|
|
K.-M. Yee, S. D. Pringle, and A. D. Struthers Circadian variation in the effects of aldosterone blockade on heart rate variability and QT dispersion in congestive heart failure J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1800 - 1807. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kornitzer Predictive value of electrocardiographic markers for autonomic nervous system dysfunction in healthy populations: more studies needed Eur. Heart J., January 2, 2001; 22(2): 109 - 112. [PDF]
|
|
|
|
|
|
E.A. Whitsel, T.E. Raghunathan, R.M. Pearce, D. Lin, P.M. Rautaharju, R. Lemaitre, and D.S. Siscovick RR interval variation, the QT interval index and risk of primary cardiac arrest among patients without clinically recognized heart disease Eur. Heart J., January 2, 2001; 22(2): 165 - 173. [Abstract] [PDF]
|
|
|
|
|
|
H. Bonnemeier, F. Hartmann, U. K. H. Wiegand, F. Bode, H. A. Katus, and G. Richardt Course and prognostic implications of QT interval and QT interval variability after primary coronary angioplasty in acute myocardial infarction J. Am. Coll. Cardiol., January 1, 2001; 37(1): 44 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Gastaldelli, M. Emdin, F. Conforti, S. Camastra, and E. Ferrannini Insulin prolongs the QTc interval in humans Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2000; 279(6): R2022 - R2025. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kakuta, Y. Maruyama, Y. Hashimoto, N. Yoshimoto, F. Numano, and T. Kato QT Dispersion in Patients with Takayasu Arteritis Angiology, September 1, 2000; 51(9): 751 - 756. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Davey QT interval lengthening in cardiac disease relates more to left ventricular systolic dysfunction than to autonomic function Eur J Heart Fail, September 1, 2000; 2(3): 265 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Okin, R. B. Devereux, B. V. Howard, R. R. Fabsitz, E. T. Lee, and T. K. Welty Assessment of QT Interval and QT Dispersion for Prediction of All-Cause and Cardiovascular Mortality in American Indians : The Strong Heart Study Circulation, January 4, 2000; 101(1): 61 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Festa, R. D'Agostino Jr, P. Rautaharju, D. H. O'Leary, M. Rewers, L. Mykkanen, and S. M. Haffner Is QT Interval a Marker of Subclinical Atherosclerosis in Nondiabetic Subjects? : The Insulin Resistance Atherosclerosis Study (IRAS) Stroke, August 1, 1999; 30(8): 1566 - 1571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. L. M. Jordaens The clinical value of QTdispersion: new perspectives on the assessment of cardiac repolarization more than 75 years after Bazett's formula Europace, January 1, 1999; 1(2): 73 - 76. [PDF]
|
|
|
|
|
|
M. Suzuki, M. Nishizaki, M. Arita, T. Ashikaga, N. Yamawake, T. Kakuta, F. Numano, and M. Hiraoka Increased QT Dispersion in Patients With Vasospastic Angina Circulation, August 4, 1998; 98(5): 435 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Schwartz, M. Stramba-Badiale, A. Segantini, P. Austoni, G. Bosi, R. Giorgetti, F. Grancini, E. D. Marni, F. Perticone, D. Rosti, et al. Prolongation of the QT Interval and the Sudden Infant Death Syndrome N. Engl. J. Med., June 11, 1998; 338(24): 1709 - 1714. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Flesch, R. H.G. Schwinger, F. Schiffer, K. Frank, M. Sudkamp, F. Kuhn-Regnier, G. Arnold, and M. Bohm Evidence for Functional Relevance of an Enhanced Expression of the Na+-Ca2+ Exchanger in Failing Human Myocardium Circulation, September 1, 1996; 94(5): 992 - 1002. [Abstract] [Full Text]
|
|
|
|
|
|
Y. S. Tuininga, H. J.G.M. Crijns, J. Brouwer, M. P. van den Berg, A. J. Man in't Veld, G. Mulder, and K.I. Lie Evaluation of Importance of Central Effects of Atenolol and Metoprolol Measured by Heart Rate Variability During Mental Performance Tasks, Physical Exercise, and Daily Life in Stable Postinfarct Patients Circulation, December 15, 1995; 92(12): 3415 - 3423. [Abstract] [Full Text]
|
|
|
|
|
|
A. A. Grace and K. R. Chien Congenital Long QT Syndromes : Toward Molecular Dissection of Arrhythmia Substrates Circulation, November 15, 1995; 92(10): 2786 - 2789. [Full Text]
|
|
|
|
 |
|
 R. R. Makkar, B. S. Fromm, R. T. Steinman, M. D. Meissner, and M. H. Lehmann Female Gender as a Risk Factor for Torsades de Pointes Associated With Cardiovascular Drugs JAMA, December 1, 1993; 270(21): 2590 - 2597. [Abstract] [PDF]
|
|
|
|
|
|
P. K. Honig, D. C. Wortham, K. Zamani, D. P. Conner, J. C. Mullin, and L. R. Cantilena Terfenadine-Ketoconazole Interaction: Pharmacokinetic and Electrocardiographic Consequences JAMA, March 24, 1993; 269(12): 1513 - 1518. [Abstract] [PDF]
|
|