BACKGROUND: The long-QT syndromes (LQTS) are inherited electrical cardiomyopathies characterized by prolonged ventricular repolarization and ventricular arrhythmias. Several genetic reports have associated defects in LQTS-causing genes with atrial fibrillation (AF). We therefore studied whether atrial arrhythmias occur in patients with LQTS under daily-life conditions. METHODS: We systematically assessed atrial arrhythmias in LQTS patients and matched controls using implanted defibrillators or pacemakers as monitors of atrial rhythm in a nested case-control study. Twenty-one LQTS patients (3 male; 39 +/- 18 years old; 18 on beta blocker, ICD therapy duration 6.3 +/- 2.7 years; 4 LQT1, 6 LQT2, 2 LQT3) were matched to 21 control subjects (13 male; 50 +/- 19 years old; 3 on beta blocker; pacemaker therapy duration 8.5 +/- 5.5 years; 19 higher-degree AV block, 2 others). LQTS patients were identified by a systematic search of the LQTS patient databases in Münster and Munich. RESULTS: One-third (7 of 21) of the LQTS patients developed self-terminating atrial arrhythmias (atrial cycle lengths <250 ms). Only one control patient developed a single episode of postoperative AF (P < 0.05 vs LQTS). CONCLUSIONS: LQTS patients at high risk for ventricular arrhythmias may develop short-lasting atrial arrhythmias under daily-life conditions, suggesting that prolonged atrial repolarization may contribute to the initiation of AF.
BACKGROUND: The long-QT syndromes (LQTS) are inherited electrical cardiomyopathies characterized by prolonged ventricular repolarization and ventricular arrhythmias. Several genetic reports have associated defects in LQTS-causing genes with atrial fibrillation (AF). We therefore studied whether atrial arrhythmias occur in patients with LQTS under daily-life conditions. METHODS: We systematically assessed atrial arrhythmias in LQTS patients and matched controls using implanted defibrillators or pacemakers as monitors of atrial rhythm in a nested case-control study. Twenty-one LQTS patients (3 male; 39 +/- 18 years old; 18 on beta blocker, ICD therapy duration 6.3 +/- 2.7 years; 4 LQT1, 6 LQT2, 2 LQT3) were matched to 21 control subjects (13 male; 50 +/- 19 years old; 3 on beta blocker; pacemaker therapy duration 8.5 +/- 5.5 years; 19 higher-degree AV block, 2 others). LQTS patients were identified by a systematic search of the LQTS patient databases in Münster and Munich. RESULTS: One-third (7 of 21) of the LQTS patients developed self-terminating atrial arrhythmias (atrial cycle lengths <250 ms). Only one control patient developed a single episode of postoperative AF (P < 0.05 vs LQTS). CONCLUSIONS: LQTS patients at high risk for ventricular arrhythmias may develop short-lasting atrial arrhythmias under daily-life conditions, suggesting that prolonged atrial repolarization may contribute to the initiation of AF.
Authors: Paulus Kirchhof; Gregory Y H Lip; Isabelle C Van Gelder; Jeroen Bax; Elaine Hylek; Stefan Kaab; Ulrich Schotten; Karl Wegscheider; Giuseppe Boriani; Axel Brandes; Michael Ezekowitz; Hans Diener; Laurent Haegeli; Hein Heidbuchel; Deirdre Lane; Luis Mont; Stephan Willems; Paul Dorian; Maria Aunes-Jansson; Carina Blomstrom-Lundqvist; Maria Borentain; Stefanie Breitenstein; Martina Brueckmann; Nilo Cater; Andreas Clemens; Dobromir Dobrev; Sergio Dubner; Nils G Edvardsson; Leif Friberg; Andreas Goette; Michele Gulizia; Robert Hatala; Jenny Horwood; Lukas Szumowski; Lukas Kappenberger; Josef Kautzner; Angelika Leute; Trudie Lobban; Ralf Meyer; Jay Millerhagen; John Morgan; Felix Muenzel; Michael Nabauer; Christoph Baertels; Michael Oeff; Dieter Paar; Juergen Polifka; Ursula Ravens; Ludger Rosin; W Stegink; Gerhard Steinbeck; Panos Vardas; Alphons Vincent; Maureen Walter; Günter Breithardt; A John Camm Journal: Europace Date: 2011-07-26 Impact factor: 5.214
Authors: Mala C Mandyam; Elsayed Z Soliman; Alvaro Alonso; Thomas A Dewland; Susan R Heckbert; Eric Vittinghoff; Steven R Cummings; Patrick T Ellinor; Bernard R Chaitman; Karen Stocke; William B Applegate; Dan E Arking; Javed Butler; Laura R Loehr; Jared W Magnani; Rachel A Murphy; Suzanne Satterfield; Anne B Newman; Gregory M Marcus Journal: Heart Rhythm Date: 2013-07-18 Impact factor: 6.343