Intracardiac QT variability in patients with structural heart disease on class III antiarrhythmic drugs

Larisa Tereshchenko, Barry J. Fetics, Ronald D. Berger

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

We previously showed that increased intracardiac repolarization lability predicts life-threatening ventricular arrhythmias in patients with structural heart disease. Patients with structural heart disease frequently take antiarrhythmic drugs (AADs), which directly affect repolarization. The effect of AADs on the predictive value of repolarization lability is unknown. We hypothesized that increased intracardiac beat-to-beat QT variability predicts sustained ventricular tachyarrhythmias in structural heart disease patients on class III AADs. Intracardiac electrograms and surface electrocardiogram were simultaneously recorded at rest for 5 minutes in 500 patients (mean ± SD age, 61 ± 14 years; 368 male [74%]) with implanted implantable cardioverter-defibrillator for primary (295 patients, or 79%) or secondary prevention of sudden cardiac death. Mean (SD) follow-up currently reached 24.8 (11.7) months. Intracardiac QT variability index was an independent predictor of ventricular tachycardia/ventricular fibrillation events and fast ventricular arrhythmias with cycle length of 240 ms or less in the multivariate Cox model. Intracardiac QT variability was higher in patients on class III AADs than in those not taking these drugs. Increased intracardiac QT variability after adjustment for class III AADs use carried independent risk of life-threatening ventricular tachyarrhythmias.

Original languageEnglish (US)
Pages (from-to)505-510
Number of pages6
JournalJournal of Electrocardiology
Volume42
Issue number6
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Anti-Arrhythmia Agents
Heart Diseases
Tachycardia
Cardiac Arrhythmias
Cardiac Electrophysiologic Techniques
Implantable Defibrillators
Sudden Cardiac Death
Ventricular Fibrillation
Ventricular Tachycardia
Secondary Prevention
Proportional Hazards Models
Electrocardiography
Pharmaceutical Preparations

Keywords

  • Intracardiac electrograms, Class III antiarrhythmic drugs
  • QT variability
  • Ventricular tachyarrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Intracardiac QT variability in patients with structural heart disease on class III antiarrhythmic drugs. / Tereshchenko, Larisa; Fetics, Barry J.; Berger, Ronald D.

In: Journal of Electrocardiology, Vol. 42, No. 6, 11.2009, p. 505-510.

Research output: Contribution to journalArticle

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