Circadian pattern of short-term variability of the QT-interval in primary prevention ICD patients - EU-CERT-ICD methodological pilot study

PLoS One

Markus Zabel¹  Anton E. Tuinenburg²  Henk J. Ritsema van Eck³  Marc A. Vos⁴  David J. Sprenkeler⁴  Marek Malik⁵ 

[1] Department of Cardiology and Pneumology, Division of Clinical Electrophysiology, University Medical Center Göttingen, Göttingen, Germany;Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands;Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, The Netherlands;National Heart & Lung Institute, Imperial College London, London, United Kingdom

关键词: Chronobiology;    Arrhythmia;    Prophylaxis;    Circadian rhythms;    Heart failure;    Pilot studies;    Dogs;    Sudden cardiac death;   

DOI  :  10.1371/journal.pone.0183199

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Objective Short-term variability of the QT-interval (STV-QT) was shown to be associated with an increased risk of ventricular arrhythmias. We aimed at investigating (a) whether STV-QT exhibits circadian pattern, and (b) whether such pattern differs between patients with high and low arrhythmia risk. Methods As part of the ongoing EU-CERT-ICD study, 24h high resolution digital ambulatory 12-lead Holter recordings are collected prior to ICD implantation for primary prophylactic indication. Presently available patients were categorized based on their arrhythmia score (AS), a custom-made weighted score of the number of arrhythmic events on the recording. STV-QT was calculated every hour in 30 patients of which 15 and 15 patients had a high and a low AS, respectively. Results The overall dynamicity of STV-QT showed high intra- and inter-individual variability with different circadian patterns associated with low and high AS. High AS patients showed a prominent peak both at 08:00 and 18:00. At these times, STV-QT was significantly higher in the high AS patients compared to the low AS patients (1.22ms±0.55ms vs 0.60ms±0.24ms at 08:00 and 1.12ms±0.39ms vs 0.64ms±0.29ms at 18:00, both p < 0.01). Conclusion In patients with high AS, STV-QT peaks in the early morning and late afternoon. This potentially reflects increased arrhythmia risk at these times. Prospective STV-QT determination at these times might thus be more sensitive to identify patients at high risk of ventricular arrhythmias.

【 授权许可】

CC BY