Document Detail


QT variability during rest and exercise in patients with implantable cardioverter defibrillators and healthy controls.
MedLine Citation:
PMID:  19149792     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Increased QT Variability (QTVI) is predictive of life threatening arrhythmias in vulnerable patients. The predictive value of QTVI is based on resting ECGs, and little is known about the effect of acute exercise on QTVI. The relation between QTVI and arrhythmic vulnerability markers such as T-wave alternans (TWA) has also not been studied. This study examined the effects of exercise on QTVI and TWA in patients with arrhythmic vulnerability. METHODS: Digitized ECGs were obtained from 47 ICD patients (43 males; age 60.9 +/- 10.1) and 23 healthy controls (18 males; age 59.7 +/- 9.5) during rest and bicycle exercise. QTVI was assessed using a previously validated algorithm and TWA was measured as both a continuous and a categorical variable based on a priori diagnostic criteria. RESULTS: QTVI increased with exercise in ICD patients (-0.79 +/- 0.11 to 0.36 +/- 0.08, P < 0.001) and controls (-1.50 +/- 0.07 to -0.19 +/- 0.12, P < 0.001), and QTVI levels were consistently higher in ICD patients than controls during rest and exercise (P < 0.001). The magnitude of QTVI increase from baseline levels was not larger among ICD patients versus controls (P > 0.20). Among ICD patients, elevated exercise QTVI was related to lower LV ejection fraction and inducibility of ischemia (P < 0.05). QTVI at rest correlated with exercise TWA (r = 0.54, P = 0.0004). CONCLUSIONS: QT variability increases significantly with exercise, and exercise QTVI is related to other well-documented markers of arrhythmic vulnerability, including low ejection fraction, inducible ischemia, and TWA. Resting QTVI may be useful in the risk stratification of individuals incapable of performing standard exercise protocols.
Authors:
Mark C Haigney; Willem J Kop; Shama Alam; David S Krantz; Pamela Karasik; Albert A DelNegro; John S Gottdiener
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc     Volume:  14     ISSN:  1542-474X     ISO Abbreviation:  Ann Noninvasive Electrocardiol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-19     Completed Date:  2009-04-09     Revised Date:  2009-07-20    
Medline Journal Info:
Nlm Unique ID:  9607443     Medline TA:  Ann Noninvasive Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. mhaigney@usuhs.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Arrhythmias, Cardiac / diagnosis*,  therapy*
Case-Control Studies
Defibrillators, Implantable*
Electrocardiography / methods*
Exercise
Female
Heart Rate / physiology
Humans
Male
Middle Aged
Probability
Prognosis
Reference Values
Rest
Risk Factors
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Ventricular Function, Left / physiology
Grant Support
ID/Acronym/Agency:
HL69751/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Ann Noninvasive Electrocardiol. 2009 Jul;14(3):309-10   [PMID:  19614645 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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