Paced QT interval is a better predictor of mortality than the intrinsic QT interval: Long-term follow-up study

Jung Myung Lee, Ajit H. Janardhan, Ki Woon Kang, Boyoung Joung, Hui Nam Pak, Srikanth Sundaram, William C. Choe, Moon Hyoung Lee, Hye Jin Hwang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated. Objective To evaluate the relationship between the paced QTc interval and mortality. Methods Of 1440 patients who underwent pacemaker implantation from January 1990 to March 2010, 766 had a recorded intrinsic and ventricular paced rhythm and were included in this study. The intrinsic and paced QTc intervals were measured on 12-lead electrocardiogram before and 1-month after implantation. Results During a mean follow-up period of 7 ± 5 years, 189 (24.4%) patients died, of which 63 (8.1%) were cardiac deaths. Compared with patients in the first tertile of the paced QTc interval (<484 ms), patients in the third tertile (>511 ms) were significantly more likely to die (19% vs 29%; P <.05). A comparison of the third and first tertiles of the QTc interval showed that a prolonged paced QTc interval was a significant independent predictor of all-cause mortality (adjusted hazard ratio 2.08; 95% confidence interval 1.44-3.01; P <.001) and cardiac mortality (adjusted hazard ratio 2.53; 95% confidence interval 1.29-4.95; P =.007) and a better predictor than was a prolonged intrinsic QTc interval. When treated as a continuous variable, a prolonged paced QTc interval predicted increased total mortality and cardiac mortality. Conclusion The paced QTc interval appears to be a more useful marker in predicting bad prognosis than does the intrinsic QTc interval in patients with indications for a permanent pacemaker.

Original languageEnglish
Pages (from-to)1184-1189
Number of pages6
JournalHeart Rhythm
Volume11
Issue number7
DOIs
Publication statusPublished - 2014 Jul

Fingerprint

Mortality
Electrocardiography
Confidence Intervals
Sudden Cardiac Death
Lead

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Lee, Jung Myung ; Janardhan, Ajit H. ; Kang, Ki Woon ; Joung, Boyoung ; Pak, Hui Nam ; Sundaram, Srikanth ; Choe, William C. ; Lee, Moon Hyoung ; Hwang, Hye Jin. / Paced QT interval is a better predictor of mortality than the intrinsic QT interval : Long-term follow-up study. In: Heart Rhythm. 2014 ; Vol. 11, No. 7. pp. 1184-1189.
@article{8b8a1ed454b74bb6aaf7088534156427,
title = "Paced QT interval is a better predictor of mortality than the intrinsic QT interval: Long-term follow-up study",
abstract = "Background Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated. Objective To evaluate the relationship between the paced QTc interval and mortality. Methods Of 1440 patients who underwent pacemaker implantation from January 1990 to March 2010, 766 had a recorded intrinsic and ventricular paced rhythm and were included in this study. The intrinsic and paced QTc intervals were measured on 12-lead electrocardiogram before and 1-month after implantation. Results During a mean follow-up period of 7 ± 5 years, 189 (24.4{\%}) patients died, of which 63 (8.1{\%}) were cardiac deaths. Compared with patients in the first tertile of the paced QTc interval (<484 ms), patients in the third tertile (>511 ms) were significantly more likely to die (19{\%} vs 29{\%}; P <.05). A comparison of the third and first tertiles of the QTc interval showed that a prolonged paced QTc interval was a significant independent predictor of all-cause mortality (adjusted hazard ratio 2.08; 95{\%} confidence interval 1.44-3.01; P <.001) and cardiac mortality (adjusted hazard ratio 2.53; 95{\%} confidence interval 1.29-4.95; P =.007) and a better predictor than was a prolonged intrinsic QTc interval. When treated as a continuous variable, a prolonged paced QTc interval predicted increased total mortality and cardiac mortality. Conclusion The paced QTc interval appears to be a more useful marker in predicting bad prognosis than does the intrinsic QTc interval in patients with indications for a permanent pacemaker.",
author = "Lee, {Jung Myung} and Janardhan, {Ajit H.} and Kang, {Ki Woon} and Boyoung Joung and Pak, {Hui Nam} and Srikanth Sundaram and Choe, {William C.} and Lee, {Moon Hyoung} and Hwang, {Hye Jin}",
year = "2014",
month = "7",
doi = "10.1016/j.hrthm.2014.04.006",
language = "English",
volume = "11",
pages = "1184--1189",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "7",

}

Paced QT interval is a better predictor of mortality than the intrinsic QT interval : Long-term follow-up study. / Lee, Jung Myung; Janardhan, Ajit H.; Kang, Ki Woon; Joung, Boyoung; Pak, Hui Nam; Sundaram, Srikanth; Choe, William C.; Lee, Moon Hyoung; Hwang, Hye Jin.

In: Heart Rhythm, Vol. 11, No. 7, 07.2014, p. 1184-1189.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Paced QT interval is a better predictor of mortality than the intrinsic QT interval

T2 - Long-term follow-up study

AU - Lee, Jung Myung

AU - Janardhan, Ajit H.

AU - Kang, Ki Woon

AU - Joung, Boyoung

AU - Pak, Hui Nam

AU - Sundaram, Srikanth

AU - Choe, William C.

AU - Lee, Moon Hyoung

AU - Hwang, Hye Jin

PY - 2014/7

Y1 - 2014/7

N2 - Background Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated. Objective To evaluate the relationship between the paced QTc interval and mortality. Methods Of 1440 patients who underwent pacemaker implantation from January 1990 to March 2010, 766 had a recorded intrinsic and ventricular paced rhythm and were included in this study. The intrinsic and paced QTc intervals were measured on 12-lead electrocardiogram before and 1-month after implantation. Results During a mean follow-up period of 7 ± 5 years, 189 (24.4%) patients died, of which 63 (8.1%) were cardiac deaths. Compared with patients in the first tertile of the paced QTc interval (<484 ms), patients in the third tertile (>511 ms) were significantly more likely to die (19% vs 29%; P <.05). A comparison of the third and first tertiles of the QTc interval showed that a prolonged paced QTc interval was a significant independent predictor of all-cause mortality (adjusted hazard ratio 2.08; 95% confidence interval 1.44-3.01; P <.001) and cardiac mortality (adjusted hazard ratio 2.53; 95% confidence interval 1.29-4.95; P =.007) and a better predictor than was a prolonged intrinsic QTc interval. When treated as a continuous variable, a prolonged paced QTc interval predicted increased total mortality and cardiac mortality. Conclusion The paced QTc interval appears to be a more useful marker in predicting bad prognosis than does the intrinsic QTc interval in patients with indications for a permanent pacemaker.

AB - Background Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated. Objective To evaluate the relationship between the paced QTc interval and mortality. Methods Of 1440 patients who underwent pacemaker implantation from January 1990 to March 2010, 766 had a recorded intrinsic and ventricular paced rhythm and were included in this study. The intrinsic and paced QTc intervals were measured on 12-lead electrocardiogram before and 1-month after implantation. Results During a mean follow-up period of 7 ± 5 years, 189 (24.4%) patients died, of which 63 (8.1%) were cardiac deaths. Compared with patients in the first tertile of the paced QTc interval (<484 ms), patients in the third tertile (>511 ms) were significantly more likely to die (19% vs 29%; P <.05). A comparison of the third and first tertiles of the QTc interval showed that a prolonged paced QTc interval was a significant independent predictor of all-cause mortality (adjusted hazard ratio 2.08; 95% confidence interval 1.44-3.01; P <.001) and cardiac mortality (adjusted hazard ratio 2.53; 95% confidence interval 1.29-4.95; P =.007) and a better predictor than was a prolonged intrinsic QTc interval. When treated as a continuous variable, a prolonged paced QTc interval predicted increased total mortality and cardiac mortality. Conclusion The paced QTc interval appears to be a more useful marker in predicting bad prognosis than does the intrinsic QTc interval in patients with indications for a permanent pacemaker.

UR - http://www.scopus.com/inward/record.url?scp=84903300961&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903300961&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2014.04.006

DO - 10.1016/j.hrthm.2014.04.006

M3 - Article

C2 - 24726972

AN - SCOPUS:84903300961

VL - 11

SP - 1184

EP - 1189

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 7

ER -