Background: Although up to 30% of short QT syndrome (SQTS) patients suffer from atrial arrhythmias, less is known about atrial repolarization abnormalities. PQ segment depression (PQD) is a well defined ECG marker of acute pericarditis. PQD is related to atrial fibrillation and carries a poor prognosis in the setting of acute inferior myocardial infarction, and it has been observed rarely during ablation of the left upper pulmonary vein. Objective: The aim of this study was to evaluate the incidence of PQD in SQTS and to analyze the association between PQD and atrial arrhythmias. Methods: Digitalized resting 12-lead ECGs of SQTS patients were analyzed for PQD in all leads and for QT and Tpeak-Tend intervals in leads II and V5. PQD was defined as l>l0.05 mV (0.5 mm) depression from the isoelectric line. The QT and Tpeak-Tend intervals were measured by a standard tangential method in leads II and V5 and were corrected according to Bazett’s formula. Results: 718 leads from 61 SQTS patients [mean age 35+18 years, 45 males (74%)] were analyzed (14 leads of three patients were missing). PQD was seen in 48 (79%) patients and in 243 (34%) leads and was more frequent in leads II, V3, V4, I, and aVF [n = 39 (64%), n = 28 (46%), n = 26 (43%), n = 24 (39%), n = 23 (38%), respectively] and also more prominent in lead II. QTc (II), QTc (V5) and Tpeak-Tend (II), Tpeak-Tend (V5) intervals were not significanty different between patients with or without PQ depression in any lead (318+33 ms, 322+29 ms, 70+11 ms, 70+14 ms; and 316+23 ms, 314+25 ms, 65+12 ms,65+12 ms; respectively, p = ns for all intervals). There was also no significant difference between patients with and without any inferior PQD. Six of 61 patients (10%) had atrial tachyarrhythmias and all 6 patients had PQD. Conclusions:48 of 61 patients with SQTS reveal PQD. As this is not observed in healthy subjects, this ECG stigma constitutes a novel marker for SQTS in addition to a short QT interval.
PQ segment depression in short QT syndrome: A novel diagnostic ECG marker?
GIUSTETTO, Carla;SCROCCO, Chiara;GAITA, Fiorenzo;
2013-01-01
Abstract
Background: Although up to 30% of short QT syndrome (SQTS) patients suffer from atrial arrhythmias, less is known about atrial repolarization abnormalities. PQ segment depression (PQD) is a well defined ECG marker of acute pericarditis. PQD is related to atrial fibrillation and carries a poor prognosis in the setting of acute inferior myocardial infarction, and it has been observed rarely during ablation of the left upper pulmonary vein. Objective: The aim of this study was to evaluate the incidence of PQD in SQTS and to analyze the association between PQD and atrial arrhythmias. Methods: Digitalized resting 12-lead ECGs of SQTS patients were analyzed for PQD in all leads and for QT and Tpeak-Tend intervals in leads II and V5. PQD was defined as l>l0.05 mV (0.5 mm) depression from the isoelectric line. The QT and Tpeak-Tend intervals were measured by a standard tangential method in leads II and V5 and were corrected according to Bazett’s formula. Results: 718 leads from 61 SQTS patients [mean age 35+18 years, 45 males (74%)] were analyzed (14 leads of three patients were missing). PQD was seen in 48 (79%) patients and in 243 (34%) leads and was more frequent in leads II, V3, V4, I, and aVF [n = 39 (64%), n = 28 (46%), n = 26 (43%), n = 24 (39%), n = 23 (38%), respectively] and also more prominent in lead II. QTc (II), QTc (V5) and Tpeak-Tend (II), Tpeak-Tend (V5) intervals were not significanty different between patients with or without PQ depression in any lead (318+33 ms, 322+29 ms, 70+11 ms, 70+14 ms; and 316+23 ms, 314+25 ms, 65+12 ms,65+12 ms; respectively, p = ns for all intervals). There was also no significant difference between patients with and without any inferior PQD. Six of 61 patients (10%) had atrial tachyarrhythmias and all 6 patients had PQD. Conclusions:48 of 61 patients with SQTS reveal PQD. As this is not observed in healthy subjects, this ECG stigma constitutes a novel marker for SQTS in addition to a short QT interval.
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