Open AccessUse of QT intervals for a more accurate diagnose of syncope and evaluation of syncope severity
Author(s) -
Buttà C.,
Tuttolomondo A.,
Casuccio A.,
Di Raimondo D.,
Giarrusso L.,
Miceli G.,
Lo Vecchio S.,
Canino B.,
Licata G.,
Pinto A.
Publication year - 2014
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/ijcp.12387
Subject(s) - medicine , syncope (phonology) , qt interval , cardiology , anesthesia
Summary Background This study aimed to evaluate the use of QT intervals, their diagnostic predictive value in patients with syncope and their relationship with syncope severity. Methods One hundred and forty nine patients with a diagnosis of syncope were admitted to Internal Medicine departments at the University of Palermo, Italy, between 2006 and 2012, and 140 control subjects hospitalised for other causes were enrolled. QT maximum, QT minimum, QT peak, QT corrected, QT dispersion and Tpeak‐to‐Tend interval were compared between two groups. The paper medical records were used for scoring with San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in SYncope Study ( EGSYS ) score and Osservatorio Epidemiologico sulla Sincope nel Lazio ( OESIL ) risk score. Results Mean QT c (p < 0.0005), mean QT max (p < 0.0005), mean QT disp (p < 0.0005), mean QT peak (p = 0.005) and mean TpTe (p = 0.018) were significantly longer in patients with syncope compared with control subjects. A QT c > 424.8 ms (sensibility: 81.88 – specificity: 57.86) showed the greatest predictive value for diagnosis of syncope. On the EGSYS score and on the OESIL score, QT c was significantly prolonged in high‐risk patients compared with low‐risk patients. On the San Francisco Syncope Rule, QT c and QT disp were significantly prolonged in high‐risk patients compared with low‐risk patients. Conclusion Mean QT c, mean QT disp, mean TpTe, mean QT max and mean QT peak were significantly longer in patients with syncope compared with control subjects. Furthermore, prolonged QT c and QT disp were associated with major severe syncope according to San Francisco Syncope Rule, EGSYS and OESIL risk scores.