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The QT interval and risk of incident atrial fibrillation.

TitleThe QT interval and risk of incident atrial fibrillation.
Publication TypeJournal Article
Year of Publication2013
AuthorsMandyam, MC, Soliman, EZ, Alonso, A, Dewland, TA, Heckbert, SR, Vittinghoff, E, Cummings, SR, Ellinor, PT, Chaitman, BR, Stocke, K, Applegate, WB, Arking, DE, Butler, J, Loehr, LR, Magnani, JW, Murphy, RA, Satterfield, S, Newman, AB, Marcus, GM
JournalHeart Rhythm
Volume10
Issue10
Pagination1562-8
Date Published2013 Oct
ISSN1556-3871
KeywordsAged, Atrial Fibrillation, Cohort Studies, Electrocardiography, Female, Humans, Incidence, Long QT Syndrome, Male, Middle Aged, Risk Factors
Abstract<p><b>BACKGROUND: </b>Abnormal atrial repolarization is important in the development of atrial fibrillation (AF), but no direct measurement is available in clinical medicine.</p><p><b>OBJECTIVE: </b>To determine whether the QT interval, a marker of ventricular repolarization, could be used to predict incident AF.</p><p><b>METHODS: </b>We examined a prolonged QT interval corrected by using the Framingham formula (QT(Fram)) as a predictor of incident AF in the Atherosclerosis Risk in Communities (ARIC) study. The Cardiovascular Health Study (CHS) and Health, Aging, and Body Composition (ABC) study were used for validation. Secondary predictors included QT duration as a continuous variable, a short QT interval, and QT intervals corrected by using other formulas.</p><p><b>RESULTS: </b>Among 14,538 ARIC study participants, a prolonged QT(Fram) predicted a roughly 2-fold increased risk of AF (hazard ratio [HR] 2.05; 95% confidence interval [CI] 1.42-2.96; P < .001). No substantive attenuation was observed after adjustment for age, race, sex, study center, body mass index, hypertension, diabetes, coronary disease, and heart failure. The findings were validated in Cardiovascular Health Study and Health, Aging, and Body Composition study and were similar across various QT correction methods. Also in the ARIC study, each 10-ms increase in QT(Fram) was associated with an increased unadjusted (HR 1.14; 95% CI 1.10-1.17; P < .001) and adjusted (HR 1.11; 95% CI 1.07-1.14; P < .001) risk of AF. Findings regarding a short QT interval were inconsistent across cohorts.</p><p><b>CONCLUSIONS: </b>A prolonged QT interval is associated with an increased risk of incident AF.</p>
DOI10.1016/j.hrthm.2013.07.023
Alternate JournalHeart Rhythm
PubMed ID23872693
PubMed Central IDPMC3787974
Grant ListN01HC55222 / HC / NHLBI NIH HHS / United States
R01-AG028050 / AG / NIA NIH HHS / United States
N01-AG-6-2101 / AG / NIA NIH HHS / United States
N01HC85239 / HC / NHLBI NIH HHS / United States
N01HC85080 / HC / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
N01-AG-6-2103 / AG / NIA NIH HHS / United States
R01-NR012459 / NR / NINR NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HL068986 / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
TL1RR024129 / RR / NCRR NIH HHS / United States
N01HC85081 / HC / NHLBI NIH HHS / United States
/ / Intramural NIH HHS / United States
N01HC85079 / HC / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
N01HC85086 / HC / NHLBI NIH HHS / United States
N01HC85082 / HC / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
R01 AG028050 / AG / NIA NIH HHS / United States
N01-AG-6-2106 / AG / NIA NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201200036C / / PHS HHS / United States
HL080295 / HL / NHLBI NIH HHS / United States
N01HC85083 / HC / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States
L30 HL078035 / HL / NHLBI NIH HHS / United States
R01 AG023629 / AG / NIA NIH HHS / United States
TL1 RR024129 / RR / NCRR NIH HHS / United States
AG023629 / AG / NIA NIH HHS / United States