Atrial Arrhythmias in Long-QT Syndrome under Daily Life Conditions: A Nested Case Control Study
STEPHAN ZELLERHOFF M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorRUDIN PISTULLI M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGEROLD MÖNNIG M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorMARTIN HINTERSEER M.D.
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorBRITT-MARIA BECKMANN M.D.
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorJULIA KÖBE M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGERHARD STEINBECK M.D., F.E.S.C.
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorSTEFAN KÄÄB M.D.
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorWILHELM HAVERKAMP M.D., F.E.S.C.
Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Virchow, Germany
Search for more papers by this authorLARISSA FABRITZ
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
Search for more papers by this authorRAINER GRADAUS M.D., F.E.S.C.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGÜNTER BREITHARDT M.D., F.E.S.C., F.A.C.C., F.H.R.S.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Search for more papers by this authorERIC SCHULZE-BAHR M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
Leibniz Institute for Arteriosclerosis Research, Münster, Germany
Search for more papers by this authorDIRK BÖCKER M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorPAULUS KIRCHHOF M.D., F.E.S.C., F.H.R.S.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Search for more papers by this authorSTEPHAN ZELLERHOFF M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorRUDIN PISTULLI M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGEROLD MÖNNIG M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorMARTIN HINTERSEER M.D.
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorBRITT-MARIA BECKMANN M.D.
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorJULIA KÖBE M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGERHARD STEINBECK M.D., F.E.S.C.
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorSTEFAN KÄÄB M.D.
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Department of Medicine 1, Cardiology, Ludwig-Maximilians-Universität, Munich, Germany
Search for more papers by this authorWILHELM HAVERKAMP M.D., F.E.S.C.
Department of Cardiology, Charité Universitätsmedizin Berlin, Campus Virchow, Germany
Search for more papers by this authorLARISSA FABRITZ
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
Search for more papers by this authorRAINER GRADAUS M.D., F.E.S.C.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorGÜNTER BREITHARDT M.D., F.E.S.C., F.A.C.C., F.H.R.S.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Search for more papers by this authorERIC SCHULZE-BAHR M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
Leibniz Institute for Arteriosclerosis Research, Münster, Germany
Search for more papers by this authorDIRK BÖCKER M.D.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Search for more papers by this authorPAULUS KIRCHHOF M.D., F.E.S.C., F.H.R.S.
Department of Cardiology and Angiology, Hospital of the University of Münster, Germany
Interdisciplinary Center for Clinical Research Münster, Germany
German Atrial Fibrillation Competence NETwork (AFNET), Munich, Germany
Search for more papers by this authorThis work was supported by the German Ministry for Education and Research (BMBF) through the German Atrial Fibrillation Competence NETwork (AFNET GI020404, projects C1 to Dr. Kirchhof, and C8 to Dr. Kaab), by Fondation Leducq (Paris), by the Deutsche Forschungsgemeinschaft (DFG: Ki731/1–1 to Dr. Kirchhof; Schu1082/3–1 and 3–2 to Dr. Schulze-Bahr; Fa 413/3–1 to Dr. Fabritz), and by IMF Münster (IMF FA120431) to Dr. Fabritz and Prof. Kirchhof).
Drs. Stephan Zellerhoff and Rudin Pistulli contributed equally to this study.
Dr. Kirchhof reports relevant consulting fees/honoraria from 3M Medica, sanofi-aventis, and Medtronic Inc.
Abstract
Background: The long-QT syndromes (LQTS) are inherited electrical cardiomyopathies characterized by prolonged ventricular repolarization and ventricular arrhythmias. Several genetic reports have associated defects in LQTS-causing genes with atrial fibrillation (AF). We therefore studied whether atrial arrhythmias occur in patients with LQTS under daily-life conditions.
Methods: We systematically assessed atrial arrhythmias in LQTS patients and matched controls using implanted defibrillators or pacemakers as monitors of atrial rhythm in a nested case-control study. Twenty-one LQTS patients (3 male; 39 ± 18 years old; 18 on β blocker, ICD therapy duration 6.3 ± 2.7 years; 4 LQT1, 6 LQT2, 2 LQT3) were matched to 21 control subjects (13 male; 50 ± 19 years old; 3 on β blocker; pacemaker therapy duration 8.5 ± 5.5 years; 19 higher-degree AV block, 2 others). LQTS patients were identified by a systematic search of the LQTS patient databases in Münster and Munich.
Results: One-third (7 of 21) of the LQTS patients developed self-terminating atrial arrhythmias (atrial cycle lengths <250 ms). Only one control patient developed a single episode of postoperative AF (P < 0.05 vs LQTS).
Conclusions: LQTS patients at high risk for ventricular arrhythmias may develop short-lasting atrial arrhythmias under daily-life conditions, suggesting that prolonged atrial repolarization may contribute to the initiation of AF.
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