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Paced QT interval is a better predictor of mortality than the intrinsic QT interval: Long-term follow-up study.

 Jung Myung Lee  ;  Ajit H. Janardhan  ;  Ki-Woon Kang  ;  Boyoung Joung  ;  Hui-Nam Pak  ;  Srikanth Sundaram  ;  William C. Choe  ;  Moon-Hyoung Lee  ;  Hye Jin Hwang 
 HEART RHYTHM, Vol.11(7) : 1184-1189, 2014 
Journal Title
Issue Date
Adult ; Aged ; Death, Sudden, Cardiac/epidemiology* ; Electrocardiography/methods* ; Female ; Follow-Up Studies ; Heart Conduction System/physiopathology ; Humans ; Incidence ; Long QT Syndrome/mortality* ; Male ; Middle Aged ; Pacemaker, Artificial/adverse effects* ; Prognosis ; Republic of Korea ; Risk Factors ; Survival Analysis
Intrinsic QTc interval ; Mortality ; Paced QTc interval ; Permanent pacemaker ; Prolonged QTc interval ; Ventricular pacing
BACKGROUND: Prolongation of the corrected QT (QTc) interval on 12-lead electrocardiogram is related to total mortality and sudden cardiac death. The value of the paced QTc interval in predicting mortality has not been investigated.
OBJECTIVE: To evaluate the relationship between the paced QTc interval and mortality.
METHODS: Of 1440 patients who underwent pacemaker implantation from January 1990 to March 2010, 766 had a recorded intrinsic and ventricular paced rhythm and were included in this study. The intrinsic and paced QTc intervals were measured on 12-lead electrocardiogram before and 1-month after implantation.
RESULTS: During a mean follow-up period of 7 ± 5 years, 189 (24.4%) patients died, of which 63 (8.1%) were cardiac deaths. Compared with patients in the first tertile of the paced QTc interval (<484 ms), patients in the third tertile (>511 ms) were significantly more likely to die (19% vs 29%; P < .05). A comparison of the third and first tertiles of the QTc interval showed that a prolonged paced QTc interval was a significant independent predictor of all-cause mortality (adjusted hazard ratio 2.08; 95% confidence interval 1.44-3.01; P < .001) and cardiac mortality (adjusted hazard ratio 2.53; 95% confidence interval 1.29-4.95; P = .007) and a better predictor than was a prolonged intrinsic QTc interval. When treated as a continuous variable, a prolonged paced QTc interval predicted increased total mortality and cardiac mortality.
CONCLUSION: The paced QTc interval appears to be a more useful marker in predicting bad prognosis than does the intrinsic QTc interval in patients with indications for a permanent pacemaker.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Lee, Jung Myung(이정명)
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hwang, Hye Jin(황혜진)
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