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QT dynamicity: a prognostic factor for sudden cardiac death in chronic heart failure
Author(s) -
Pathak Atul,
Curnier Daniel,
Fourcade Joëlle,
Roncalli Jéme,
Stein Phyllis K.,
Hermant Patricia,
Bousquet Marc,
Massabuau Pierre,
Sénard JeanMichel,
Montastruc JeanLouis,
Galinier Michel
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.10.016
Subject(s) - medicine , cardiology , heart failure , sudden death , confidence interval , sinus rhythm , qt interval , sudden cardiac death , relative risk , electrocardiography , atrial fibrillation
The aim of this study was to determine whether impaired adaptation of the QT interval to changes in heart rate predicts sudden death in patients with chronic heart failure (CHF). Methods: We prospectively included 175 CHF patients in sinus rhythm. QT dynamicity was evaluated by analyzing 24‐h Holter recordings. The linear regression slope of QT interval measured to the apex and to the end of T wave plotted against RR intervals was calculated using a dedicated Holter algorithm. Results: Mean follow‐up was 29.9±17.9 months. There were 48 deaths, of which 21 were sudden. The actuarial 3‐year mortality rates were 38.4% for overall mortality and 14.1% for sudden death. Of all the parameters, an increased QTe/RR slope (>0.28) was the strongest independent predictor of sudden death (relative risk 3.47, 95% confidence interval 1.43−8.40, p =0.006). Conclusion: Increased 24‐h QTe dynamicity is independently predictive of sudden death among patients with heart failure. This simple parameter may help to stratify risk and select patients who may benefit from antiarrhythmic prophylaxis.