Document Detail

QTc Compared to the JTc for Monitoring of Drug-Induced Repolarization, Changes In the Setting of Ventricular Pacing.
MedLine Citation:
PMID:  24252288     Owner:  NLM     Status:  Publisher    
BACKGROUND: QT prolongation is a risk factor for proarrhythmia when beginning antiarrhythmic drug therapy (AAD). However, there are no data regarding monitoring repolarization changes during a ventricular paced (VP) rhythm.
OBJECTIVE: The purpose of this study is to compare serial changes in corrected QT and JT intervals, during native conduction (NC) and VP rhythms when initiating Class III AAD.
METHODS: 22 patients (73% men, age 65±11 years) with an implantable device and with <10% VP were monitored during AAD initiation (sotalol, n=16; dofetilide, n=6). QTc and JTc were measured from ECGs obtained during NC and VP at baseline (pre-AAD) and then following each AAD dose.
RESULTS: During AAD loading, the mean QTc increased significantly during NC (431 ± 28 ms to 463 ± 33 ms, p=0.002), but not with VP (520 ± 48 ms to 538 ± 45 ms, p=0.07). The mean percent increase in peak QTc during NC was significantly greater than during VP (12% vs. 7%, p=0.003). In contrast, the peak JTc during AAD loading was not significantly different between NC and VP (p=0.67).
CONCLUSION: When initiating AAD, the change in QTc during VP does not correlate with the change in QTc during NC, and thus the VP QTc is inadequate for monitoring repolarization changes. However, VP JTc correlates well with JTc during NC. When initiating Class III AAD in patients with VP rhythms, the JTc, and not the QTc, interval is the useful marker to assess repolarization.
Shane F Tsai; Mahmoud Houmsse; Barrah Dakhil; Ralph Augostini; John D Hummel; Steven J Kalbfleisch; Zhengou Liu; Charles Love; Troy Rhodes; Jaret Tyler; Raul Weiss; Ismail Hamam; Marshall Winner; Emile G Daoud
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-16
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Published by Heart Rhythm Society on behalf of Heart Rhythm Society.
Section of Electrophysiology, Division of Cardiology, Ross Heart Hospital, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
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