Time-Dependent Changes in QT Dynamics after Initiation and Termination of Paroxysmal Atrial Fibrillation

Yoshiaki Yamaguchi; Koichi Mizumaki; Kunihiro Nishida; Tamotsu Sakamoto; Naoya Kataoka; Yosuke Nakatani; Hiroshi Inoue

doi:10.1111/pace.12746

Time-Dependent Changes in QT Dynamics after Initiation and Termination of Paroxysmal Atrial Fibrillation

Yoshiaki Yamaguchi, Koichi Mizumaki^*, Kunihiro Nishida, Tamotsu Sakamoto, Naoya Kataoka, Yosuke Nakatani, Hiroshi Inoue

^*Corresponding author for this work

Internal Medicine （2）

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background Little is known about time-dependent changes in QT dynamics after initiation of atrial fibrillation (AF) and after restoration of sinus rhythm (SR) in patients with paroxysmal AF. Methods Beat-to-beat QT and RR intervals in CM5 lead were measured automatically in 13 patients with both AF and SR on the single 24-hour Holter electrocardiology recording. QT-RR relation was analyzed at six periods of time: 1 hour before AF onset (Pre_0-1h), 0-1 hour and 4-5 hours after AF onset (AF_0-1h and AF_4-5h), and 0-1 hour, 2-3 hours, and 4-5 hours after the restoration of SR (SR_0-1h, SR_2-3h, and SR_4-5h). Results QT-RR slope was gradually decreased after AF onset and gradually returned to the baseline level after restoration of SR. The slope became greater at SR_4-5h than at AF_4-5h and AF_0-1h. In patients receiving antiarrhythmic drugs (AADs; n = 5), QT-RR slope was greater at SR_4-5h than in those not receiving AADs (n = 8). Conclusion In patients with paroxysmal AF, bradycardia-dependent QT prolongation was attenuated during AF, and was corrected and gradually augmented along with continuation of SR, especially in patients receiving AADs. This could increase the risk of developing torsade de pointes.

Original language	English
Pages (from-to)	1418-1424
Number of pages	7
Journal	PACE - Pacing and Clinical Electrophysiology
Volume	38
Issue number	12
DOIs	https://doi.org/10.1111/pace.12746
State	Published - 2015/12/01

Keywords

Holter ECG recording
QT interval
QT-RR relation
atrial fibrillation
torsade de pointes

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1111/pace.12746

Cite this

@article{bb4f3600b6f8405abaeb26181e4e0be3,

title = "Time-Dependent Changes in QT Dynamics after Initiation and Termination of Paroxysmal Atrial Fibrillation",

abstract = "Background Little is known about time-dependent changes in QT dynamics after initiation of atrial fibrillation (AF) and after restoration of sinus rhythm (SR) in patients with paroxysmal AF. Methods Beat-to-beat QT and RR intervals in CM5 lead were measured automatically in 13 patients with both AF and SR on the single 24-hour Holter electrocardiology recording. QT-RR relation was analyzed at six periods of time: 1 hour before AF onset (Pre0-1h), 0-1 hour and 4-5 hours after AF onset (AF0-1h and AF4-5h), and 0-1 hour, 2-3 hours, and 4-5 hours after the restoration of SR (SR0-1h, SR2-3h, and SR4-5h). Results QT-RR slope was gradually decreased after AF onset and gradually returned to the baseline level after restoration of SR. The slope became greater at SR4-5h than at AF4-5h and AF0-1h. In patients receiving antiarrhythmic drugs (AADs; n = 5), QT-RR slope was greater at SR4-5h than in those not receiving AADs (n = 8). Conclusion In patients with paroxysmal AF, bradycardia-dependent QT prolongation was attenuated during AF, and was corrected and gradually augmented along with continuation of SR, especially in patients receiving AADs. This could increase the risk of developing torsade de pointes.",

keywords = "Holter ECG recording, QT interval, QT-RR relation, atrial fibrillation, torsade de pointes",

author = "Yoshiaki Yamaguchi and Koichi Mizumaki and Kunihiro Nishida and Tamotsu Sakamoto and Naoya Kataoka and Yosuke Nakatani and Hiroshi Inoue",

note = "Publisher Copyright: {\textcopyright}2015 Wiley Periodicals, Inc.",

year = "2015",

month = dec,

day = "1",

doi = "10.1111/pace.12746",

language = "英語",

volume = "38",

pages = "1418--1424",

journal = "PACE - Pacing and Clinical Electrophysiology",

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publisher = "John Wiley and Sons Inc.",

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T1 - Time-Dependent Changes in QT Dynamics after Initiation and Termination of Paroxysmal Atrial Fibrillation

AU - Yamaguchi, Yoshiaki

AU - Mizumaki, Koichi

AU - Nishida, Kunihiro

AU - Sakamoto, Tamotsu

AU - Kataoka, Naoya

AU - Nakatani, Yosuke

AU - Inoue, Hiroshi

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background Little is known about time-dependent changes in QT dynamics after initiation of atrial fibrillation (AF) and after restoration of sinus rhythm (SR) in patients with paroxysmal AF. Methods Beat-to-beat QT and RR intervals in CM5 lead were measured automatically in 13 patients with both AF and SR on the single 24-hour Holter electrocardiology recording. QT-RR relation was analyzed at six periods of time: 1 hour before AF onset (Pre0-1h), 0-1 hour and 4-5 hours after AF onset (AF0-1h and AF4-5h), and 0-1 hour, 2-3 hours, and 4-5 hours after the restoration of SR (SR0-1h, SR2-3h, and SR4-5h). Results QT-RR slope was gradually decreased after AF onset and gradually returned to the baseline level after restoration of SR. The slope became greater at SR4-5h than at AF4-5h and AF0-1h. In patients receiving antiarrhythmic drugs (AADs; n = 5), QT-RR slope was greater at SR4-5h than in those not receiving AADs (n = 8). Conclusion In patients with paroxysmal AF, bradycardia-dependent QT prolongation was attenuated during AF, and was corrected and gradually augmented along with continuation of SR, especially in patients receiving AADs. This could increase the risk of developing torsade de pointes.

AB - Background Little is known about time-dependent changes in QT dynamics after initiation of atrial fibrillation (AF) and after restoration of sinus rhythm (SR) in patients with paroxysmal AF. Methods Beat-to-beat QT and RR intervals in CM5 lead were measured automatically in 13 patients with both AF and SR on the single 24-hour Holter electrocardiology recording. QT-RR relation was analyzed at six periods of time: 1 hour before AF onset (Pre0-1h), 0-1 hour and 4-5 hours after AF onset (AF0-1h and AF4-5h), and 0-1 hour, 2-3 hours, and 4-5 hours after the restoration of SR (SR0-1h, SR2-3h, and SR4-5h). Results QT-RR slope was gradually decreased after AF onset and gradually returned to the baseline level after restoration of SR. The slope became greater at SR4-5h than at AF4-5h and AF0-1h. In patients receiving antiarrhythmic drugs (AADs; n = 5), QT-RR slope was greater at SR4-5h than in those not receiving AADs (n = 8). Conclusion In patients with paroxysmal AF, bradycardia-dependent QT prolongation was attenuated during AF, and was corrected and gradually augmented along with continuation of SR, especially in patients receiving AADs. This could increase the risk of developing torsade de pointes.

KW - Holter ECG recording

KW - QT interval

KW - QT-RR relation

KW - atrial fibrillation

KW - torsade de pointes

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U2 - 10.1111/pace.12746

DO - 10.1111/pace.12746

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C2 - 26391623

AN - SCOPUS:84958111871

SN - 0147-8389

VL - 38

SP - 1418

EP - 1424

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

IS - 12

ER -

Time-Dependent Changes in QT Dynamics after Initiation and Termination of Paroxysmal Atrial Fibrillation

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