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

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 hospita...

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Main Authors: Simon W. Rabkin, Jacky K. K. Tang
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2020/2858149
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author Simon W. Rabkin
Jacky K. K. Tang
author_facet Simon W. Rabkin
Jacky K. K. Tang
author_sort Simon W. Rabkin
collection DOAJ
description 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.
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spelling doaj-art-945367e1d68941e580ec5f65e89045302025-08-20T03:37:24ZengWileyCardiology Research and Practice2090-80162090-05972020-01-01202010.1155/2020/28581492858149The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial FibrillationSimon W. Rabkin0Jacky K. K. Tang1Division of Cardiology, University of British Columbia, Vancouver, CanadaDivision of Cardiology, University of British Columbia, Vancouver, CanadaA 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.http://dx.doi.org/10.1155/2020/2858149
spellingShingle Simon W. Rabkin
Jacky K. K. Tang
The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
Cardiology Research and Practice
title The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
title_full The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
title_fullStr The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
title_full_unstemmed The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
title_short The Short QTc Is a Marker for the Development of Atrial Flutter and Atrial Fibrillation
title_sort short qtc is a marker for the development of atrial flutter and atrial fibrillation
url http://dx.doi.org/10.1155/2020/2858149
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