Prolonged QRS duration on the resting ECG is associated with sudden death risk in coronary disease, independent of prolonged ventricular repolarization

Carmen Teodorescu, Kyndaron Reinier, Audrey Uy-Evanado, Jo Navarro, Ronald Mariani, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

Background: Abnormalities of ventricular repolarization as well as depolarization have been associated with increased risk of ventricular arrhythmias. Objective: To evaluate the relative contribution of these predictors to risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD). Methods: In the ongoing Oregon Sudden Unexpected Death Study, adult residents from the Portland, Oregon, metropolitan area (population ∼1 million) who suffered SCD were identified prospectively (20022007). Of these, we analyzed the subgroup of SCDs that had a resting 12-lead ECG prior to SCD and also had associated CAD. Comparisons were conducted with a control group of subjects with known CAD but no history of SCD from the same geographic region. Corrected QT interval (QTc), JT interval (JTc), QRS duration (QRSd), and other parameters were measured from ECG prior and unrelated to SCD. Analysis of left ventricular function was limited to those subjects who had undergone echocardiography prior to and remote from SCD. Results: A total of 642 SCD cases (71 ± 13 years, 62% male) were compared to 450 controls (66 ± 12 years, 64% male). SCD cases had significantly longer QRSd (102 ± 25 ms vs 97 ± 20 ms, P =.0008) as well as JTc (348 ± 44 ms vs 339 ± 34 ms, P =.0006) vs controls. In cases with prolonged QRSd, 38% had severe left ventricular systolic dysfunction and 62% had normal, mild, or moderately decreased left ventricular systolic function. In a multivariable model, QRSd, JTc, age, and severe left ventricular systolic dysfunction were independent predictors. There was minimal overlap between prolonged QRSd and JTc in both case and control groups (3% and 4%, respectively). Conclusion: Prolonged QRSd, JTc, and severe left ventricular systolic dysfunction had independent contributions to risk of SCD in coronary disease, in this community-based setting.

Original languageEnglish (US)
Pages (from-to)1562-1567
Number of pages6
JournalHeart Rhythm
Volume8
Issue number10
DOIs
StatePublished - Oct 2011

Keywords

  • Epidemiology
  • electrocardiogram
  • population
  • predictor
  • prevention
  • risk
  • stratification
  • sudden cardiac death
  • ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Prolonged QRS duration on the resting ECG is associated with sudden death risk in coronary disease, independent of prolonged ventricular repolarization'. Together they form a unique fingerprint.

  • Cite this