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The QT interval.

M M Bednar¹, E P Harrigan, R J Anziano

¹Worldwide Clinical Development-CNS, Pfizer Inc, Groton, CT 06340, USA.

Progress in Cardiovascular Diseases

|March 28, 2001

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See all related articles

The corrected QT interval (QTc) is an important, though imprecise, marker for cardiovascular disease risk. Careful QTc measurements help assess drug therapy benefits and arrhythmia risks, especially for drug-induced torsade de pointes.

Area of Science:

Cardiology
Pharmacology
Epidemiology

Background:

QT interval variations are linked to torsade de pointes and sudden cardiac death.
Factors like heart rate correction, ECG leads, genetics, and environment complicate QT interval interpretation.
The corrected QT interval (QTc) is a recognized, yet imperfect, cardiovascular disease marker.

Purpose of the Study:

To review the epidemiologic literature on QT interval effects in disease and drug therapy.
To clarify the relationship between QTc prolongation and cardiovascular mortality and arrhythmia risk.
To inform the benefit-risk assessment of drug therapies concerning QTc prolongation.

Main Methods:

Comprehensive review of epidemiologic literature.
Analysis of factors confounding QT interval interpretation.

Related Experiment Videos

Evaluation of drug-induced QTc prolongation and arrhythmia risk.

Main Results:

QTc prolongation is associated with mortality in cardiac patients, but this link is less clear in non-cardiac patients.
Drug-induced QTc prolongation increases torsade de pointes risk, particularly when QTc exceeds 500 ms.
Non-cardiac drug proarrhythmic capacity varies, with drug interactions significantly contributing to arrhythmia risk.

Conclusions:

Careful QTc measurement, considering confounding variables, is crucial for accurate risk assessment.
Understanding QTc prolongation helps establish a more precise benefit-risk ratio for drug therapies.
This knowledge aids in evaluating arrhythmia risk from pathophysiologic states and genetic factors.