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Microvolt T‐Wave Alternans in Short QT Syndrome
Author(s) -
MAURY PHILIPPE,
EXTRAMIANA FABRICE,
GIUSTETTO CARLA,
CARDIN CRISTELLE,
ROLLIN ANNE,
DUPARC ALEXANDRE,
MONDOLY PIERRE,
DENJOY ISABELLE,
DELAY MARC,
MESSALI ANNE,
LEENHARDT ANTOINE,
MARANGONI DANIELE
Publication year - 2012
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2012.03491.x
Subject(s) - medicine , t wave alternans , short qt syndrome , cardiology , asymptomatic , sudden cardiac death , ventricular fibrillation , implantable cardioverter defibrillator , ventricular tachycardia , qt interval , sudden death , long qt syndrome
Background:T‐wave alternans (TWA) is an accepted marker of risk for malignant ventricular arrhythmias, for which prognosis value has been established in different populations. Short QT syndrome (SQTS) is a very rare primary electrical disease carrying the risk of ventricular fibrillation. TWA in SQTS has not been evaluated yet.Methods:Thirteen patients with SQTS (QT = 308 ± 16 ms, QTc = 329 ± 10 ms, heart rate = 69 ± 8 beats/min) underwent microvolt TWA measurement using spectral analysis. TWA testing was performed using Heartwave II (Cambridge Heart™, Inc., Bedford, MA, USA) during bicycle exercice and classified as negative, positive, or indeterminate according to the published standards for clinical interpretation.Results:Twelve patients were male (mean age 23 ± 5 years). Five were asymptomatic, three presented with aborted sudden cardiac death, and five with unexplained syncope. Six patients belonged to two unrelated families, while familial cases of SQTS were present for two other patients. A familial history of sudden death (SD) was present for seven patients. Ventricular fibrillation was inducible in three patients. Four patients were implanted with an implantable cardioverter‐defibrillator and one presented with polymorphic ventricular tachycardia during follow‐up. TWA was negative in each but one patient (indeterminate). Maximal negative heart rate was 118 ± 12 beats/min. Patients with previous SD displayed significant shorter QT and higher resting heart rate compared to the remaining cases.Conclusions:TWA testing is negative in 12 of 13 SQTS patients, even in the symptomatic or inducible ones. Measurement of TWA using conventional protocol and criteria for risk stratification in SQTS seems therefore useless. (PACE 2012;35:1413–1419)