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  • Impact of QTc formulae in the prevalence of short corrected QT interval and impact on probability and diagnosis of short QT syndrome

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Arrhythmias and sudden death
Original research article
Impact of QTc formulae in the prevalence of short corrected QT interval and impact on probability and diagnosis of short QT syndrome
  1. Rui Providência1,2,
  2. Nabeela Karim1,
  3. Neil Srinivasan1,
  4. Shohreh Honarbakhsh1,
  5. Maria João Vidigal Ferreira3,4,
  6. Lino Gonçalves3,4,
  7. Eloi Marijon5,6,
  8. Pier D Lambiase1,7
  1. 1 Barts Heart Centre, Barts Health NHS Trust, London, UK
  2. 2 Farr Institute of Health Informatics, University College of London, London, UK
  3. 3 Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
  4. 4 Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
  5. 5 Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France
  6. 6 AP-HP, Service de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France
  7. 7 Institute of Cardiovascular Science, University College of London, London, UK
  1. Correspondence to Dr Rui Providência, Barts Heart Centre, Barts Health NHS Trust, West Smithfield London EC1A 7BE, UK; rui_providencia{at}yahoo.com

Abstract

Objective To assess the prevalence of short corrected QT (QTc) intervals and its impact on short QT syndrome (SQTS) diagnosis using different QT correction formulae.

Methods Observational study. The prevalence of short QTc intervals was estimated using four different QT correction formulae in 14 662 young adults from the ‘Sudden Cardiac Death Screening of Risk FactOrS’ (SCD-SOS) cohort. Then, using data from this cohort and the pooled-cohort analysed by Gollob et al, comprising 61 patients with SQTS, we assessed the impact of the different QTc correction formulae on SQTS probability and diagnosis based on the Expert Consensus recommendations (QTc ≤330 ms or QTc 330–360 ms+1 additional risk feature).

Results The prevalence of individuals with a QTc ≤330 and ≤320 ms in the SCD-SOS cohort was extremely low (≤0.07% and≤0.02%, respectively), and these were more frequently identified by the Framingham correction. The different QTc correction formulae led to a shift in SQTS probability in 5%–10% of individuals in both the SCD-SOS and Gollob cohort). Intermediate probability individuals were rare (<0.1%), and no high-SQTS probability individuals were identified in the SCD-SOS cohort. Based on Consensus criteria, instead of 12 (0.08%) individuals being diagnosed with SQTS using the Bazett equation, a different number of individuals would meet diagnostic criteria with the other formulae: 11 (0.08%) using Fridericia, 9 (0.06%) with Hodges and 16 (0.11%) using the Framingham equation.

Conclusion Prevalence of SQTS in the apparently healthy adult population is low. Applying different QTc correction formulae leads to significant reclassification of SQTS probability and their impact on predicting outcomes should be assessed.

  • arrhythmia
  • channelopathies
  • sudden cardiac death
  • ion channel
  • prevention

https://doi.org/10.1136/heartjnl-2017-311673

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    Footnotes

    • Contributors RP had the idea of developing the SCD-SOS survey protocol, and discussed it with MJVF and LG, which later helped in developing it. Later, RP discussed the possibility of a short QT subanalysis with PDL, and this was performed with the help of NK and NS. RP prepared the first draft of the manuscript which was revised by PDL, and later by all authors. The final version of the manuscript was prepared and revised by all authors before the final approval and submission of the manuscript.

    • Competing interests RP has received training grant from Boston Scientific, and Sorin Group and a Research Grant from Medtronic. PDL has research grants and speaker fees from Boston Scientific, St Jude, Research Grants from Medtronic and Biotronik. He is supported by UCLH Biomedicine NIHR. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

    • Patient consent Obtained.

    • Ethics approval Local Ethics Committee (Hospital Geral do Centro Hospital e Universitário de Coimbra), Portuguese Central Health Region (Administração Regional de Saúde do Centro)—355/Sec/10/03/2011.

    • Provenance and peer review Not commissioned; externally peer reviewed.