Nixiao Zhang1, Mengqi Gong1, Gary Tse2,3,4, Zhiwei Zhang1, Lei Meng1, Bryan P Yan2,5, Ling Zhang6, Gang Wu7, Yunlong Xia8, Gan Xin-Yan9,10, Guangping Li1, Tong Liu1. 1. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, P.R. China. 2. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, P.R. China. 3. Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, P.R. China. 4. School of Health Sciences, University of Manchester, Manchester, United Kingdom. 5. Department of Epidemiology and Preventive Medicine, Monash University, Clayton, VIC, Australia. 6. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, P.R. China. 7. Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Wuhan, Hubei, P.R. China. 8. Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, P.R. China. 9. Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, PA, USA. 10. Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Abstract
BACKGROUND: Corrected QT interval (QTc) on the electrocardiogram is a marker of ventricular repolarization. Recent studies have examined its value in predicting the occurrence of atrial fibrillation (AF). METHODS AND RESULTS: We conducted a meta-analysis to determine whether alterations in QTc interval are associated with an increased risk of incident AF. The PUBMED and EMBASE databases were searched for all studies that evaluated the incident AF associated with prolonged QTc interval published before December 2016. Sensitivity and subgroup analysis were subsequently performed. A total of six studies including eight data sets for prolonged QTc interval were eligible. Subjects with prolonged QTc interval as a categorical variable had a significantly higher risk of AF during follow-up (hazard ratio [HR]: 1.16; 95% confidence interval [CI], 1.09-1.24, I2 = 90%) based on Bazett formula. In continuous variable analysis, we found a statistically significant risk for AF (HR, 1.17; 95% CI, 1.09-1.25; I2 = 0) every 10-ms prolongation in QTc. AF type, QTc cut-off value, geographical location, follow-up duration, and study population may be the possible reasons for the significant heterogeneity among the studies. CONCLUSIONS: Prolonged QTc interval is associated with an increased risk of AF. And the potential mechanisms underlying this cause-and-effect relationship need further investigation.
BACKGROUND: Corrected QT interval (QTc) on the electrocardiogram is a marker of ventricular repolarization. Recent studies have examined its value in predicting the occurrence of atrial fibrillation (AF). METHODS AND RESULTS: We conducted a meta-analysis to determine whether alterations in QTc interval are associated with an increased risk of incident AF. The PUBMED and EMBASE databases were searched for all studies that evaluated the incident AF associated with prolonged QTc interval published before December 2016. Sensitivity and subgroup analysis were subsequently performed. A total of six studies including eight data sets for prolonged QTc interval were eligible. Subjects with prolonged QTc interval as a categorical variable had a significantly higher risk of AF during follow-up (hazard ratio [HR]: 1.16; 95% confidence interval [CI], 1.09-1.24, I2 = 90%) based on Bazett formula. In continuous variable analysis, we found a statistically significant risk for AF (HR, 1.17; 95% CI, 1.09-1.25; I2 = 0) every 10-ms prolongation in QTc. AF type, QTc cut-off value, geographical location, follow-up duration, and study population may be the possible reasons for the significant heterogeneity among the studies. CONCLUSIONS: Prolonged QTc interval is associated with an increased risk of AF. And the potential mechanisms underlying this cause-and-effect relationship need further investigation.
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