Key result
ECG criteria including ~67% early repolarization differentiate SQTS patients from healthy controls.
Why the study?
There may be overlap in QTc between SQTS patients and normal subjects in childhood and adolescence, complicating diagnosis.
Do specific electrocardiographic criteria (QTcB, J-Tpeak cB, and early repolarization) improve the differentiation of short QT syndrome from healthy subjects with short QTc in children and adolescents?
Case-Control (n=95)
Yes
Do specific electrocardiographic criteria (QTcB, J-Tpeak cB, and early repolarization) improve the differentiation of short QT syndrome from healthy subjects with short QTc in children and adolescents?
Absolute Event Rate: 67% vs 23%
p-value: p=0.001
A QTcB <316 ms, J-Tpeak cB <181 ms, and the presence of early repolarization can help differentiate short QT syndrome from normal subjects with short QTc in children and adolescents.
These ECG thresholds may aid pediatric short QT syndrome differentiation; hypothesis-generating and requires prospective validation.
AIMS: Although shortening of the corrected QT interval (QTc) is a key finding in the diagnosis of short QT syndrome (SQTS), there may be overlap of the QTc between SQTS patients and normal subjects in childhood and adolescence. We aimed to investigate electrocardiographic findings for differentiation of SQTS patients. METHODS AND RESULTS: The SQTS group comprised 34 SQTS patients <20 years old, including 9 from our institutions and 25 from previous reports. The control group comprised 61 apparently healthy subjects with an QTc of <360 ms who were selected from 13 314 participants in a school-based screening programme. We compared electrocardiographic findings, including QT and Jpoint-Tpeak intervals (QT and J-Tpeak, respectively), those corrected by using the Bazett's and Fridericia's formulae (cB and cF, respectively) and early repolarization (ER) between the groups. QT, QTc by using Bazett's formula (QTcB), QTc by using Fridericia's formula (QTcF), J-Tpeak, J-Tpeak cB, and J-Tpeak cF were significantly shorter in the SQTS group than in the control group. On receiver operating characteristic curve analysis, the area under the curve (AUC) was largest for QTcB (0.888) among QT, QTcB, and QTcF, with a cut-off value of 316 ms (sensitivity: 79.4% and specificity: 96.7%). The AUC was largest for J-Tpeak cB (0.848) among J-Tpeak, J-Tpeak cB, and J-Tpeak cF, with a cut-off value of 181 ms (sensitivity: 80.8% and specificity: 91.8%). Early repolarization was found more frequently in the SQTS group than in the control group (67% vs. 23%, P = 0.001). CONCLUSION: A QTcB <316 ms, J-Tpeak cB < 181 ms, and the presence of ER may indicate SQTS patients in childhood and adolescence.
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Suzuki et al. (2021) conducted a case-control in Short QT syndrome (n=95). Electrocardiographic criteria vs. Healthy subjects was evaluated on Early repolarization frequency (p=0.001). Electrocardiographic criteria including QTcB <316 ms, J-Tpeak cB <181 ms, and early repolarization (67% vs 23%, P=0.001) differentiated short QT syndrome patients from healthy controls.
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