Catecholamine-provoked microvoltage t wave alternans in genotyped long qt syndrome.

Macrovoltage T wave alternans (TWA) has been described in congenital long QT syndrome (LQTS). Microvoltage T wave alternans (microV-TWA) at low heart rate (HR) is a marker of arrhythmogenic risk in many conditions, but its significance in LQTS has not been established. Twenty-three genotypically het...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 26; no. 8; pp. 1660 - 1668
Autores principales: Nemec J, Ackerman MJ, Tester DJ, Hejlik J, Shen W
Formato: research Journal Article
Publicado: Wiley-Blackwell Aug2003
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2003
      vid: 26
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1046/j.1460-9592.2003.t01-1-00249.x
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        atl: Catecholamine-provoked microvoltage t wave alternans in genotyped long qt syndrome.
      aug:
        au:
          Nemec J
          Ackerman MJ
          Tester DJ
          Hejlik J
          Shen W
      sug:
        subj:
          Adrenergic beta-Agonists Pharmacodynamics
          Dobutamine Pharmacodynamics
          Long QT Syndrome Complications
          Long QT Syndrome
          Tachycardia, Ventricular Etiology
          Tachycardia, Ventricular
          Adolescence
          Adult
          Case Control Studies
          Electrocardiography
          Female
          Genotype
          Male
          Nonparametric Statistics
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
          Male
      ab: Macrovoltage T wave alternans (TWA) has been described in congenital long QT syndrome (LQTS). Microvoltage T wave alternans (microV-TWA) at low heart rate (HR) is a marker of arrhythmogenic risk in many conditions, but its significance in LQTS has not been established. Twenty-three genotypically heterogeneous patients with LQTS and 16 control subjects were studied at rest and during phenylephrine and dobutamine provocation. Genotyping was established by PCR amplification and DNA sequencing of the three most common LQTS genes; KCNQ1/KVLQT1 (LQT1), KCNH2/HERG (LQT2), and SCN5A (LQT3). microV-TWA was determined using Fast Fourier transform. Precluded by ectopy, microV-TWA could not be assessed in 8 of 23 patients with LQTS. In the remaining 15 patients with LQTS, microV-TWA occurred at lower HR in LQTS than in controls (117 +/- 49 vs 153 +/- 37 beats/min; P < 0.05). Patients with LQTS developed microV-TWA at HR < 150 beats/min more often than controls (10/15 vs 2/16; P = 0.003). However, microV-TWA was not detected in the 3 individuals with a history of out-of-hospital cardiac arrest including a 14-year-old male with an F339del-KVLQT1 mutation (LQT1) who had dobutamine-provoked polymorphic ventricular tachycardia requiring external defibrillation. Catecholamine-provoked microV-TWA occurs at lower HR in patients with LQTS than in healthy people but does not identify high risk subjects.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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