Cited by 126Cardiac electrophysiology and arrhythmiasHeart Rate Variability and Autonomic ControlCardiac pacing and defibrillation studies

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Beat-to-beat variability of QT intervals is increased in patients with drug-induced long-QT syndrome: a case control pilot study

Hinterseer, M., Thomsen, M. B., Beckmann, B.-M., Pfeufer, A., Schimpf, R., Wichmann, H.-E., Steinbeck, G., Vos, M. A., Kaab, S.·2007·European Heart Journal

DOI 10.1093/eurheartj/ehm586

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Abstract

AIMS: Torsades de pointes arrhythmias (TdP) occur by definition in the setting of prolonged QT intervals. Animal models of drug induced Long-QT syndrome (dLQTS) have shown higher predictive value for proarrhythmia with beat-to-beat variability of repolarization duration (BVR) when compared with QT intervals. Here, we evaluate variability of QT intervals in patients with a history of drug-induced long QT syndrome (dLQTS) and TdP in absence of a mutation in any of the major LQTS genes. METHODS AND RESULTS: Twenty patients with documented TdP under drugs with QT-prolonging potential were compared with 20 matched control individuals. An observer blinded to diagnosis manually measured lead-II, RR, and QT intervals from 30 consecutive beats. BVR was determined from Poincaré plots of QT intervals as short-term variability (STV(QT) = Sigma|QT(n)(+1) - QT(n)|/[30 x radical2]). QRS interval and cycle length was comparable between study groups and controls. No difference was found in QTc between dLQTS and controls (428 +/- 25 vs. 421 +/- 34 ms, P = 0.26), whereas STV(QT) was significantly higher in dLQTS when compared with controls (8.1 +/- 3.7 vs. 3.6 +/- 1.3 ms, P = 0.001). Proarrhythmic predictive power of STV(QT) was superior to that of the QTc interval (AUC: 0.89 vs. 0.57, 95% CI: 0.79-0.99 vs. 0.39-0.75). CONCLUSION: In the absence of QTc prolongation, baseline STV(QT) characterized patients with documented drug-induced proarrhythmia. STV(QT) could prove to be a useful non-invasive, easily obtainable parameter aiding the identification of the patient at risk for potentially life threatening arrhythmia in the context of drugs with QT prolonging potential.

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Authors: Hinterseer, M., Thomsen, M. B., Beckmann, B.-M., Pfeufer, A., Schimpf, R., Wichmann, H.-E., Steinbeck, G., Vos, M. A., & Kaab, S.
Affiliations: LMU Klinikum (DE)
Helmholtz Munich (DE)
University Medical Centre Mannheim (DE)
Corresponding author: Hinterseer, M.
ORCID: Hinterseer, M.
Thomsen, M. B.
Wichmann, H.-E.
Vos, M. A.
Venue: European Heart Journal
Publisher: Oxford University Press (OUP)
Published: 2007-12-12
Volume: 29
Issue: 2
Pages: 185-190
ISSN: 0195-668X (ISSN-L)
1522-9645
DOI: 10.1093/eurheartj/ehm586
OpenAlex: W2067418531
Cited by: 126
References: 29
Citations by year: 2026: 4 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 5 · 2018: 2 · 2017: 8 · 2016: 5 · 2015: 8 · 2014: 8 · 2013: 12 · 2012: 10
FWCI: 6.55
Type: journal article
Language: en
Open access: closed
Locations: European Heart Journal (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion)
mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
Site cant be reached (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords: drug-induced long QT syndrome, torsades de pointes, drug-induced arrhythmia, QTc prolongation, Poincaré plot, short-term variability, QT-prolonging drugs, risk stratification
MeSH terms: Aged, Arrhythmias, Cardiac, Disease Susceptibility, Electrocardiography, Female, Heart Rate, Humans, Long QT Syndrome, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Case-Control Studies, Torsades de Pointes

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Beat-to-beat variability of QT intervals is increased in patients with drug-induced long-QT syndrome: a case control pilot study

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