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Ann Noninvasive Electrocardiol. 2014 Sep;19(5):490-500. doi: 10.1111/anec.12157. Epub 2014 May 14.

Short QT in a cohort of 1.7 million persons: prevalence, correlates, and prognosis.

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1
Division of Research, Kaiser Permanente, Oakland, CA.

Abstract

BACKGROUND:

Short QT syndrome (QTc ≤ 300 ms) is a novel hereditary channelopathy linked to syncope, paroxysmal atrial fibrillation, and sudden cardiac death. However, its epidemiological features remain unsettled.

OBJECTIVES:

(1) To assess the prevalence of short QT in a large population-based sample; (2) to evaluate its demographic and clinical correlates and; (3) to determine its prognosis.

METHODS:

A database of 6.4 million electrocardiograms (ECGs) obtained between 1995 and 2008 among 1.7 million persons was used. An internal, population-based method for heart rate correction (QTcreg ) was used and all ECGs with QTcreg ≤300 ms were manually validated. Linked health plan databases were used for covariate and survival ascertainment.

RESULTS:

Of 6,387,070 ECGs, 1086 had an ECG with machine-read QTcreg ≤300 ms. Only 4% (45/1086) were validated yielding a prevalence of 0.7 per 100,000 or 1 of 141,935 ECGs. At the person level, the overall prevalence of QTcreg ≤300 ms was 2.7 per 100,000 or 1 of 37,335. The factors independently and significantly associated with validated QTcreg ≤300 ms were age over 65 years, Black race, prior history of ventricular dysrhythmias, chronic obstructive pulmonary disease, ST-T abnormalities, ischemia, bigeminy pattern, and digitalis effect. After 8.3 years of median follow-up and relative to normal QTcreg , validated QTcreg ≤300 ms was associated after multivariate adjustment with a 2.6-fold (95% confidence interval [CI] = 1.9-3.7) increased risk of death.

CONCLUSION:

QTcreg ≤300 ms was extraordinarily rare and was associated with significant ECG abnormalities and reduced survival.

KEYWORDS:

QT interval; epidemiology; prognosis; short QT syndrome

PMID:
24829126
DOI:
10.1111/anec.12157
[Indexed for MEDLINE]
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