Key result
Patients with long-QT syndrome developed significantly more self-terminating atrial arrhythmias under daily-life conditions compared to matched controls (33.3% vs 4.8%; P<0.05).
Why the study?
Do patients with Long-QT Syndrome have a higher incidence of atrial arrhythmias under daily-life conditions compared to matched controls?
Case-Control (n=42)
Yes
Do patients with Long-QT Syndrome have a higher incidence of atrial arrhythmias under daily-life conditions compared to matched controls?
Absolute Event Rate: 33.3% vs 4.8%
p-value: p=<0.05
Patients with Long-QT syndrome have a significantly higher incidence of short-lasting atrial arrhythmias under daily-life conditions compared to matched controls, suggesting prolonged atrial repolarization may contribute to atrial fibrillation initiation.
Atrial arrhythmias may occur in high-risk LQTS; leaves open whether routine screening alters management.
BACKGROUND: The long-QT syndromes (LQTS) are inherited electrical cardiomyopathies characterized by prolonged ventricular repolarization and ventricular arrhythmias. Several genetic reports have associated defects in LQTS-causing genes with atrial fibrillation (AF). We therefore studied whether atrial arrhythmias occur in patients with LQTS under daily-life conditions. METHODS: We systematically assessed atrial arrhythmias in LQTS patients and matched controls using implanted defibrillators or pacemakers as monitors of atrial rhythm in a nested case-control study. Twenty-one LQTS patients (3 male; 39 +/- 18 years old; 18 on beta blocker, ICD therapy duration 6.3 +/- 2.7 years; 4 LQT1, 6 LQT2, 2 LQT3) were matched to 21 control subjects (13 male; 50 +/- 19 years old; 3 on beta blocker; pacemaker therapy duration 8.5 +/- 5.5 years; 19 higher-degree AV block, 2 others). LQTS patients were identified by a systematic search of the LQTS patient databases in Münster and Munich. RESULTS: One-third (7 of 21) of the LQTS patients developed self-terminating atrial arrhythmias (atrial cycle lengths <250 ms). Only one control patient developed a single episode of postoperative AF (P < 0.05 vs LQTS). CONCLUSIONS: LQTS patients at high risk for ventricular arrhythmias may develop short-lasting atrial arrhythmias under daily-life conditions, suggesting that prolonged atrial repolarization may contribute to the initiation of AF.
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Zellerhoff et al. (2008) conducted a case-control in Long-QT Syndrome (n=42). Long-QT Syndrome vs. Matched controls was evaluated on Self-terminating atrial arrhythmias (atrial cycle lengths <250 ms) (p=<0.05). Patients with long-QT syndrome developed significantly more self-terminating atrial arrhythmias under daily-life conditions compared to matched controls (33.3% vs 4.8%; P<0.05).
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