[Ventricular arrhythmias and the ATc index in patients with ischemic heart disease]

J Foremny1, E Nowalany-Kozielska, P Buszman

  • 1I Klinika Kardiologii IK Sl. AM w Katowicach.

Kardiologia Polska
|January 1, 1990
PubMed

Insights

Prolonged QT corrected (QTc) intervals were not linked to ventricular arrhythmias in ischemic heart disease patients. However, increased QTc was associated with a higher incidence of documented ventricular tachycardia/fibrillation (VT/VF).

Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Ischemic heart disease (IHD) patients often exhibit arrhythmias.
  • QTc interval prolongation is a risk factor for cardiac events.
  • The relationship between QTc prolongation and ventricular arrhythmias in IHD requires further clarification.

Purpose of the Study:

  • To investigate the association between QTc interval prolongation and ventricular arrhythmias in patients with ischemic heart disease.
  • To compare QTc values across different Lown's criteria for ventricular arrhythmias.
  • To determine if QTc prolongation predicts the occurrence of sustained ventricular tachycardia/fibrillation (VT/VF).

Main Methods:

  • A multicenter study included 1,011 IHD patients.
  • Standard 12-lead ECG and 24-hour ambulatory ECG monitoring were performed.
  • QTc interval was calculated using Bazett's formula; prolonged QTc was defined as >440 ms.
  • Ventricular ectopic activity was classified using Lown's criteria.

Main Results:

  • No significant differences in mean QTc values were found across Lown's arrhythmia classes.
  • The prevalence of prolonged QTc was similar between low-grade (0-2) and high-grade (3-5) arrhythmias (21% vs. 28%).
  • Patients with a history of documented VT/VF showed a higher incidence of QTc prolongation (35% vs. 20%, p=0.043).

Conclusions:

  • QTc prolongation is not directly correlated with the presence or severity of ventricular arrhythmias in IHD patients.
  • Increased QTc interval may be a risk factor for the occurrence of VT/VF in this population.
  • Further research is needed to elucidate the predictive value of QTc prolongation for adverse events in IHD.

Related Concept Videos

Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
ECG Interpretation of Arrhythmias I: Sinus Arrhythmias01:16

ECG Interpretation of Arrhythmias I: Sinus Arrhythmias

Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism, and...
Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...