Author/Authors :
Tabatabaei، Peyman نويسنده Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran , , Keikhavani، Ala نويسنده Department of Cardiology, Ziaeian General Hospital, International Campus Medical School, Tehran University of Medical Sciences, Tehran, IR Iran , , Haghjoo، Majid نويسنده Echocardiography Research Center, Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. , , Fazelifar، Amirfarjam نويسنده Assistant Professor of Cardiology, Cardiac Electrophysiology Research Center, Rajaie Cardiovascular, Medical and Research Center , , Emkanjoo، Zahra نويسنده Department of cardiology, Iran University of Medical Sciences , , Zeighami، Mahbobeh نويسنده Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran , , Bakhshandeh، Hooman نويسنده , , Ghadrdoost، Behshid نويسنده Laboratory of Learning and Memory, Research Center and Department of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. , , Alizadeh Diz، Abolfath نويسنده Cardiac Electrophysiology Research Center, Shaheed Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Ira ,
Abstract :
Prolongation of the QT interval is considered a risk factor for cardiac adverse events and mortality. Left bundle branch block (LBBB) lengthens the QT interval. The corrected QT interval (QTc) is most likely overestimated because its prolongation is caused by increases in depolarization duration and not in repolarization. In this study, we aimed to apply corrected JT interval (JTc) as an appropriate measure of ventricular repolarization for predicting QTc in a formula. The study population consisted of 101 patients with sinus rhythm (SR) and narrow QRS complexes (< 120 milliseconds). All patients underwent electrophysiology studies or ablation. A diagnostic catheter was positioned in the right ventricular apex (RVA) to induce LBBB at two different cycle lengths (CLs; 600 and 700 mv). The intrinsic QRS complex, QT time, and JT time were measured during SR and subsequent RVA pacing. The JTc was derived simply by subtracting the QRS duration from the QTc. Stimulation from the RVA increased the QTc from 456.20 ± 38.63 ms to 530.67 ± 47.73 ms at a CL of 600 (P < 0.0001) and to 502.32 ± 47.26 ms at 700 CL (P < 0.0001). JTc showed no significant changes with stimulation from the RVA (102.97 ± 11.35 ms vs. 103.59 ± 10.67 ms, P = 0.24). There was no significant correlation between JTc and QRS complex duration. A significant correlation was seen between QRS and QTc at both CLs. The ROC curve indicated that sensitivity of 80% and specificity of 67% were obtained with JTc duration of 92.6 ms. Right ventricular pacing increases the QT interval without increasing the JT interval. Our results confirm that JTc, as an index of repolarization, is independent of ventricular depolarization. Therefore, it can be applied for predicting QTc in patients with LBBB.
