KCNQ1 Polymorphism in the Context of Ischemic Cardiomyopathy: A Potential Key to Decision‐Making for Device Implantation

BACKGROUND: Ventricular tachyarrhythmia (VTA) in ischemic cardiomyopathy (ICM) is a life-threatening condition influenced by genetic factors and electrical remodeling. This study investigated the association between KCNQ1 gene polymorphisms (rs2237892 and rs2237895) and the development of VTA in ICM patients to improve risk stratification and guide device implantation decisions. METHODS: This single-center study included 213 ICM patients with implantable cardioverter-defibrillators (ICD) for primary prevention of VTA. Patients were divided into arrhythmia and control groups based on device interrogation findings. Genetic analysis for rs2237892 and rs2237895 polymorphisms was performed using real-time polymerase chain reaction (PCR). Clinical, electrocardiographic, and laboratory parameters were analyzed. Correlation and logistic regression analyses evaluated the association between KCNQ1 polymorphisms and VTA risk. RESULTS: The arrhythmia group demonstrated significantly higher QT dispersion, frontal QRS-T angle, and T-wave peak-to-end interval compared to the control group. The TT genotype of rs2237892 and the AC genotype of rs2237895 were significantly associated with increased VTA risk (p < 0.001). Multivariate analysis confirmed these genotypes as independent predictors of VTA. No significant differences in other clinical or laboratory risk factors were observed. CONCLUSIONS: KCNQ1 gene polymorphisms (rs2237892 and rs2237895) are strongly associated with VTA in ICM patients, suggesting a potential role as biomarkers for risk stratification. These findings may assist in tailoring ICD implantation decisions and improving patient outcomes.