QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy

Salma I. Patel, Michael John Ackerman, Fadi E. Shamoun, Jeffrey B. Geske, Steve R. Ommen, William T. Love, Stephen S. Cha, Johan M. Bos, Steven Jay Lester

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Risk assessment for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains complex. The goal of this study was to assess electrocardiogram (ECG)-derived risk factors on SCD in a large HCM population Methods: Retrospective review of adults with HCM evaluated at Mayo Clinic, Rochester, MN from 1 December 2002 to 31 December 2012 was performed. Data inclusive of ECG and 24-hour ambulatory Holter monitor were assessed. SCD events were documented by ventricular fibrillation (VF) noted on implantable cardioverter defibrillator (ICD), or appropriate VT or VF-terminating ICD shock. Results: Overall, 1615 patients (mean age 53.7 ± 15.2 years; 943 males, 58.4%) were assessed, with mean follow-up 2.46 years and 110 SCD events. Via logistic regression (n = 820), the odds of SCD increased with increasing number of conventional risk factors. With one risk factor the OR was 4.88 (p < .0001; CI 2.22–10.74), two risk factors the OR was 6.922 (p < .0001; CI 2.94–16.28) and three or more risk factors, the OR was 13.997 (p < .0001; CI 5.649–34.68). Adding QTc > 450 to this logistic regression model had OR 1.722 (p = .04, CI 1.01–2.937) to predict SCD. QTc ≥ 450 was a significant predictor for death (HR 1.88, p = .021, CI 1.10–3.20). There was no correlation between sinus bradycardia, sinus tachycardia, first degree AV block, atrial fibrillation, left bundle branch block, right bundle branch block, premature atrial complexes, premature ventricular complexes, supraventricular tachycardia, PR interval, QRS interval and SCD. Conclusions: Prolonged QTc was a risk factor for SCD and death even when controlling for typical risk factors.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalActa Cardiologica
DOIs
StateAccepted/In press - Mar 6 2018

Fingerprint

Hypertrophic Cardiomyopathy
Sudden Cardiac Death
Bundle-Branch Block
Implantable Defibrillators
Logistic Models
Ventricular Fibrillation
Electrocardiography
Atrial Premature Complexes
Sinus Tachycardia
Supraventricular Tachycardia
Ventricular Premature Complexes
Atrioventricular Block
Bradycardia
Atrial Fibrillation
Shock
Population

Keywords

  • electrocardiography
  • Holter
  • Hypertrophic cardiomyopathy
  • QTc
  • sudden cardiac death

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy. / Patel, Salma I.; Ackerman, Michael John; Shamoun, Fadi E.; Geske, Jeffrey B.; Ommen, Steve R.; Love, William T.; Cha, Stephen S.; Bos, Johan M.; Lester, Steven Jay.

In: Acta Cardiologica, 06.03.2018, p. 1-6.

Research output: Contribution to journalArticle

Patel, Salma I. ; Ackerman, Michael John ; Shamoun, Fadi E. ; Geske, Jeffrey B. ; Ommen, Steve R. ; Love, William T. ; Cha, Stephen S. ; Bos, Johan M. ; Lester, Steven Jay. / QT prolongation and sudden cardiac death risk in hypertrophic cardiomyopathy. In: Acta Cardiologica. 2018 ; pp. 1-6.
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AU - Patel, Salma I.

AU - Ackerman, Michael John

AU - Shamoun, Fadi E.

AU - Geske, Jeffrey B.

AU - Ommen, Steve R.

AU - Love, William T.

AU - Cha, Stephen S.

AU - Bos, Johan M.

AU - Lester, Steven Jay

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N2 - Introduction: Risk assessment for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains complex. The goal of this study was to assess electrocardiogram (ECG)-derived risk factors on SCD in a large HCM population Methods: Retrospective review of adults with HCM evaluated at Mayo Clinic, Rochester, MN from 1 December 2002 to 31 December 2012 was performed. Data inclusive of ECG and 24-hour ambulatory Holter monitor were assessed. SCD events were documented by ventricular fibrillation (VF) noted on implantable cardioverter defibrillator (ICD), or appropriate VT or VF-terminating ICD shock. Results: Overall, 1615 patients (mean age 53.7 ± 15.2 years; 943 males, 58.4%) were assessed, with mean follow-up 2.46 years and 110 SCD events. Via logistic regression (n = 820), the odds of SCD increased with increasing number of conventional risk factors. With one risk factor the OR was 4.88 (p < .0001; CI 2.22–10.74), two risk factors the OR was 6.922 (p < .0001; CI 2.94–16.28) and three or more risk factors, the OR was 13.997 (p < .0001; CI 5.649–34.68). Adding QTc > 450 to this logistic regression model had OR 1.722 (p = .04, CI 1.01–2.937) to predict SCD. QTc ≥ 450 was a significant predictor for death (HR 1.88, p = .021, CI 1.10–3.20). There was no correlation between sinus bradycardia, sinus tachycardia, first degree AV block, atrial fibrillation, left bundle branch block, right bundle branch block, premature atrial complexes, premature ventricular complexes, supraventricular tachycardia, PR interval, QRS interval and SCD. Conclusions: Prolonged QTc was a risk factor for SCD and death even when controlling for typical risk factors.

AB - Introduction: Risk assessment for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) remains complex. The goal of this study was to assess electrocardiogram (ECG)-derived risk factors on SCD in a large HCM population Methods: Retrospective review of adults with HCM evaluated at Mayo Clinic, Rochester, MN from 1 December 2002 to 31 December 2012 was performed. Data inclusive of ECG and 24-hour ambulatory Holter monitor were assessed. SCD events were documented by ventricular fibrillation (VF) noted on implantable cardioverter defibrillator (ICD), or appropriate VT or VF-terminating ICD shock. Results: Overall, 1615 patients (mean age 53.7 ± 15.2 years; 943 males, 58.4%) were assessed, with mean follow-up 2.46 years and 110 SCD events. Via logistic regression (n = 820), the odds of SCD increased with increasing number of conventional risk factors. With one risk factor the OR was 4.88 (p < .0001; CI 2.22–10.74), two risk factors the OR was 6.922 (p < .0001; CI 2.94–16.28) and three or more risk factors, the OR was 13.997 (p < .0001; CI 5.649–34.68). Adding QTc > 450 to this logistic regression model had OR 1.722 (p = .04, CI 1.01–2.937) to predict SCD. QTc ≥ 450 was a significant predictor for death (HR 1.88, p = .021, CI 1.10–3.20). There was no correlation between sinus bradycardia, sinus tachycardia, first degree AV block, atrial fibrillation, left bundle branch block, right bundle branch block, premature atrial complexes, premature ventricular complexes, supraventricular tachycardia, PR interval, QRS interval and SCD. Conclusions: Prolonged QTc was a risk factor for SCD and death even when controlling for typical risk factors.

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