| The Diagnostic Utility of Recovery Phase QTc During Treadmill Exercise Stress Testing in the Evaluation of Long QT Syndrome. | |
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MedLine Citation:
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PMID: 21699858 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Nearly 40% of patients with long QT syndrome (LQTS) can have a non-diagnostic QTc at rest. Treadmill and cycle exercise stress testing are used in the diagnostic evaluation of LQTS. OBJECTIVE: We sought to determine the diagnostic significance of peak exercise and recovery phase QTc values during treadmill stress testing in LQTS. METHODS: An IRB-approved, retrospective analysis was performed on the treadmill stress tests in 243 patients including 82 LQT1, 55 LQT2, 18 LQT3, and 88 genotype negative patients dismissed as normal. Blinded to genotype, QTc was calculated at rest, peak exercise, and 1, 2, 3, 4, and 5 minutes of recovery. RESULTS: Compared to those dismissed as normal, the average QTc was greater at all scored stages in LQT1 and LQT3 patients and all stages in LQT2 patients except peak exercise and 1 minute of recovery (p < 0.01). Either an absolute QTc ≥ 460 ms during the recovery phase or a maladaptive, paradoxical increase in QTc, defined as QTc recovery - QTc baseline ≥ 30 ms (ΔQTc), distinguished patients with either manifest or concealed LQT1 from all other subsets (p < 0.0001). The presence of beta blockers did not blunt these abnormal repolarization profiles. CONCLUSION: Treadmill stress testing can unmask patients with concealed LQTS, particularly LQT1, with good diagnostic accuracy. |
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Authors:
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Justin M Horner; Melissa M Horner; Michael J Ackerman |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-30 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: - ISSN: 1556-3871 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-6-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011. Published by Elsevier Inc. |
Affiliation:
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Department of Pediatric and Adolescent Medicine/Division of Pediatric Cardiology, Mayo Clinic, 200 First Street SW, Rochester, MN, USA, 55905. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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