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Pacing Clin Electrophysiol. 2016 Dec;39(12):1366-1372. doi: 10.1111/pace.12962. Epub 2016 Nov 10.

The QT Interval as a Noninvasive Marker of Atrial Refractoriness.

Author information

1
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California.
2
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California.

Abstract

BACKGROUND:

Atrial refractoriness may be an important determinant of atrial fibrillation (AF) risk, but its measurement is not clinically accessible. Because the QT interval predicts incident AF and the atrium and ventricle share repolarizing ion currents, we investigated the association between an individual's QT interval and atrial effective refractory period (AERP).

METHODS:

In paroxysmal AF patients presenting for catheter ablation, the QT interval was measured from the surface 12-lead electrocardiogram. The AERP was defined as the longest S1-S2 coupling interval without atrial capture using a 600-ms drive cycle length.

RESULTS:

In 28 patients, there was a positive correlation between QTc and mean AERP. After multivariate adjustment, a 1-ms increase in QTc predicted a 0.70-ms increase in AERP.

CONCLUSIONS:

The QTc interval reflects the AERP, suggesting that the QTc interval may be used as a marker of atrial refractoriness relevant to assessing AF risk and mechanism-specific therapeutic strategies.

KEYWORDS:

QT interval; atrial fibrillation; refractory period

PMID:
27753113
PMCID:
PMC5195901
DOI:
10.1111/pace.12962
[Indexed for MEDLINE]
Free PMC Article

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