Andreas Reusser1, Steffen Blum2, Stefanie Aeschbacher1, Lucien Eggimann1, Peter Ammann3, Paul Erne4, Giorgio Moschovitis5, Marcello Di Valentino6, Dipen Shah7, Jürg Schläpfer8, Samuel Manser9, Tobias Reichlin1, Michael Kühne1, Christian Sticherling1, Stefan Osswald1, David Conen10. 1. Division of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland. 2. Division of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Division of Internal Medicine, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland. 3. Division of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland. 4. Laboratory for Signal Transduction, Department of Biomedicine, University Hospital Basel, Basel, Switzerland. 5. Division of Cardiology, Ospedale Regionale di Lugano, Ticino, Switzerland. 6. Division of Cardiology, Ospedale San Giovanni Bellinzona, Ticino, Switzerland. 7. Division of Cardiology, University Hospital Geneva, Geneva, Switzerland. 8. Service of Cardiology, University Hospital Lausanne, Lausanne, Switzerland. 9. Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland. 10. Division of Cardiology, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland; Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Electronic address: conend@mcmaster.ca.
Abstract
BACKGROUND: A longer QTc interval has been associated with more adverse cardiovascular events and death in the general population. Little evidence is available on these relationships among patients with atrial fibrillation (AF). METHODS: We performed a prospective observational multicenter cohort study of 1413 patients with AF. A resting 12‑lead electrocardiogram (ECG) was performed at baseline. QT interval was corrected for heart rate using the Bazett formula (QTc). Endpoints for this study included hospitalizations for congestive heart failure (CHF), a combination of cardiovascular death, myocardial infarction, stroke, systemic arterial embolism (MACE) and all-cause mortality. RESULTS: Mean age of our population was 68±12years and 420 (30%) participants were female. Median QTc was 432ms (interquartile range 409; 457). The mean follow-up time was 3.6±1.5years. After multivariable adjustment, there was a linear increase in risk with increasing QTc interval for incident CHF (hazard ratio (HR) per 1-SD increase in QTc 1.3 [95% CI 1.1; 1.6], p=0.008), MACE (HR 1.2 [1.0; 1.4], p=0.02) and all-cause mortality (HR 1.3 [1.0; 1.6], p=0.002). Results were consistent whether or not patients were in sinus rhythm on the baseline ECG (HR for CHF 1.7 versus 1.3, p interaction 0.08; HR for MACE 1.3 versus 1.2, p interaction 0.9; HR for all-cause mortality 1.4 versus 1.4, p interaction 0.9). CONCLUSIONS: In this large well-characterized cohort of AF patients, QTc interval was independently associated with adverse outcomes. These results were independent of the rhythm on the baseline ECG.
BACKGROUND: A longer QTc interval has been associated with more adverse cardiovascular events and death in the general population. Little evidence is available on these relationships among patients with atrial fibrillation (AF). METHODS: We performed a prospective observational multicenter cohort study of 1413 patients with AF. A resting 12‑lead electrocardiogram (ECG) was performed at baseline. QT interval was corrected for heart rate using the Bazett formula (QTc). Endpoints for this study included hospitalizations for congestive heart failure (CHF), a combination of cardiovascular death, myocardial infarction, stroke, systemic arterial embolism (MACE) and all-cause mortality. RESULTS: Mean age of our population was 68±12years and 420 (30%) participants were female. Median QTc was 432ms (interquartile range 409; 457). The mean follow-up time was 3.6±1.5years. After multivariable adjustment, there was a linear increase in risk with increasing QTc interval for incident CHF (hazard ratio (HR) per 1-SD increase in QTc 1.3 [95% CI 1.1; 1.6], p=0.008), MACE (HR 1.2 [1.0; 1.4], p=0.02) and all-cause mortality (HR 1.3 [1.0; 1.6], p=0.002). Results were consistent whether or not patients were in sinus rhythm on the baseline ECG (HR for CHF 1.7 versus 1.3, p interaction 0.08; HR for MACE 1.3 versus 1.2, p interaction 0.9; HR for all-cause mortality 1.4 versus 1.4, p interaction 0.9). CONCLUSIONS: In this large well-characterized cohort of AFpatients, QTc interval was independently associated with adverse outcomes. These results were independent of the rhythm on the baseline ECG.
Authors: Murat Bilgi; Yusuf Velioglu; Hamit Yoldas; Mehmet Cosgun; Ahmet Yuksel; Ibrahim Karagoz; Isa Yildiz; Abdulhamit Es; Duygu Caliskan; Kemalettin Erdem; Abdullah Demirhan Journal: Braz J Cardiovasc Surg Date: 2020-06-01
Authors: Neha Mantri; Meng Lu; Jonathan G Zaroff; Neil Risch; Thomas Hoffmann; Akinyemi Oni-Orisan; Catherine Lee; Eric Jorgenson; Carlos Iribarren Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501