Prolonged QTc Interval and Risk of Sudden Cardiac Death in a Population of Older Adults
Open accessAbstract
Objectives This study sought to investigate whether prolongation of the heart rate-corrected QT (QTc) interval is a risk factor for sudden cardiac death in the general population.Background In developed countries, sudden cardiac death is a major cause of cardiovascular mortality. Prolongation of the QTc interval has been associated with ventricular arrhythmias, but in most population-based studies no consistent association was found between QTc prolongation and total or cardiovascular mortality. Only very few of these studies specifically addressed sudden cardiac death.Methods This study was conducted as part of the Rotterdam Study, a prospective population-based cohort study that comprises 3,105 men and 4,878 women aged 55 years and older. The QTc interval on the electrocardiogram was determined during the baseline visit (1990 to 1993) and the first follow-up examination (1993 to 1995). The association between a prolonged QTc interval and sudden cardiac death was estimated using Cox proportional hazards analysis.Results During an average follow-up period of 6.7 years (standard deviation, 2.3 years) 125 patients died of sudden cardiac death. An abnormally prolonged QTc interval (>450 ms in men, >470 ms in women) was associated with a three-fold increased risk of sudden cardiac death (hazard ratio, 2.5; 95% confidence interval, 1.3 to 4.7), after adjustment for age, gender, body mass index, hypertension, cholesterol/high-density lipoprotein ratio, diabetes mellitus, myocardial infarction, heart failure, and heart rate. In patients with an age below the median of 68 years, the corresponding relative risk was 8.0 (95% confidence interval 2.1 to 31.3).Conclusions Abnormal QTc prolongation on the electrocardiogram should be viewed as an independent risk factor for sudden cardiac death.
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Changes in autonomic tone can directly influence the QT interval, prolongation of which disrupts the electrophysiological environment.
“Furthermore, changes in autonomic tone can directly influence the QT interval, prolongation of which disrupts the electrophysiolocal environment.10”
From Caffeine delays autonomic recovery following acute exercise (2015) · cites this paper as [10]
The introductory passage (page not provided) says QT prolongation has been associated with ventricular arrhythmias that may trigger sudden cardiac death, supporting a connection to electrical disturbances. It does not say that changes in autonomic tone directly influence the QT interval or establish that prolongation disrupts the electrophysiological environment. (LLM, conf=0.78)
Experimental — accuracy not yet measuredProlongation of the QT interval can disrupt the electrophysiological environment, leading to ventricular instability and the risk of cardiac arrhythmias/cardiac death.
“In addition, prolongation of the QT interval can disrupt the electrophysiolocal environment, leading to ventricular instability and the risk of cardiac arrhythmias/cardiac death.10”
From Caffeine delays autonomic recovery following acute exercise (2015) · cites this paper as [10]
The paper’s background states that QT prolongation has been associated with ventricular arrhythmias that may trigger ventricular fibrillation and sudden cardiac death. Its Discussion also reports an increased risk of sudden cardiac death with prolonged QTc. It does not establish that QT prolongation disrupts the electrophysiological environment or causes ventricular instability; page numbers were unavailable in our copy. (LLM, conf=0.85)
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- Authors
- Straus, S. M. J. M., Kors, J. A., De Bruin, M. L., van der Hooft, C. S., Hofman, A., Heeringa, J., Deckers, J. W., Kingma, J. H., Sturkenboom, M. C. J. M., Stricker, B. H. C., & Witteman, J. C. M.
- Affiliations
- Erasmus MC (NL)
- University of Groningen (NL)
- Corresponding author
- Stricker, Bruno H. Ch.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-01
- Volume
- 47
- Issue
- 2
- Pages
- 362-367
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1988368217
- Semantic Scholar
- ec55864581f38c0dd6f9499954ba4be67b7f208e
- Cited by
- 833
- References
- 38
- Citations by year
- 2026: 28 · 2025: 27 · 2024: 37 · 2023: 40 · 2022: 48 · 2021: 62 · 2020: 46 · 2019: 44 · 2018: 36 · 2017: 50 · 2016: 55 · 2015: 48 · 2014: 51 · 2013: 48 · 2012: 36
- FWCI
- 25.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Digest of the World Core Medical Journals(Cardiology)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- QTc prolongation, sudden cardiac death, electrocardiogram, older adults, risk factors, ventricular arrhythmias, cardiovascular mortality, Rotterdam Study
- MeSH terms
- Aged, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Netherlands, Risk Factors, Confounding Factors, Epidemiologic, Proportional Hazards Models, Death, Sudden, Cardiac, Risk Assessment
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