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Background : Skin sympathetic nerve activity (SKNA) and QT interval variability are known to be associated with ventricular arrhythmias. However, the relationship between the two remains unclear.   Objective : The aim was to test the hypothesis that SKNA bursts are associated with greater short-term variability of the QT interval (STVQT) in patients with electrical storm (ES) or coronary heart disease without arrhythmias (CHD) than in healthy volunteers (HV).   Methods : We simultaneously recorded the ECG and SKNA during sinus rhythm in patients with ES ( N  = 10) and CHD ( N  = 8) and during cold-water pressor test in HV ( N  = 12). The QT and QTc intervals were manually marked and calculated within the ECG. The STVQT was calculated and compared to episodes of SKNA burst and non-bursting activity.   Results : The SKNA burst threshold for ES and HV was 1.06 ± 1.07 and 1.88 ± 1.09 μV, respectively ( p  = 0.011). During SKNA baseline and burst, the QT/QTc intervals and STVQT for ES and CHD were significantly higher than those of the HV. In all subjects, SKNA bursts were associated with an increased STVQT (from 6.43 ± 2.99 to 9.40 ± 5.12 ms,  p  = 0.002 for ES; from 9.48 ± 4.40 to 12.8 ± 5.26 ms,  p  = 0.016 for CHD; and from 3.81 ± 0.73 to 4.49 ± 1.24 ms,  p  = 0.016 for HV). The magnitude of increased STVQT in ES (3.33 ± 3.06 ms) and CHD (3.34 ± 2.34 ms) was both higher than that of the HV (0.68 ± 0.84 ms,  p  = 0.047 and  p  = 0.020).   Conclusion : Compared to non-bursting activity, SKNA bursts were associated with a larger increase in the QTc interval and STVQT in patients with heart disease than in HV.

Skin Sympathetic Nerve Activity and the Short-Term QT Interval Variability in Patients With Electrical Storm