The QT Interval as a Noninvasive Marker of Atrial Refractoriness

Nguyen, Tim; Gladstone, A B A Rachel; Dukes, Jonathan W.; Nazer, Babak; Vittinghoff, Eric; Badhwar, Nitish; Vedantham, Vasanth; Gerstenfeld, Edward P.; Lee, Byron K.; Lee, Randall J.; Tseng, Zian H.; Olgin, Jeffrey E.; Scheinman, Melvin M.; Marcus, Gregory M.

doi:10.1111/pace.12962

Cited by 14 publications

(8 citation statements)

References 26 publications

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“…A prolonged QT‐interval has been shown to predict the development of AF, and longer QTc intervals increase the heart's vulnerability to ventricular dysrhythmias [31]. Prolonged QTc intervals also reflect the atrial effective refractory period (AERP) [32], and a prolonged AERP is associated with an increased risk of AF [33]. A high sodium intake may affect QT‐interval length.…”

Section: Discussionmentioning

confidence: 99%

Estimated salt intake and risk of atrial fibrillation in a prospective community‐based cohort

et al. 2020

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Introduction. Hypertension predisposes to atrial fibrillation (AF)a major risk factor for ischaemic stroke. Since a high dietary salt consumption is associated with hypertension, we investigated the association between urinary sodium excretion as a marker for dietary sodium intake and risk of newonset AF in community-dwelling adults.Method. The UK Biobank includes 40-to 69-year-old British residents recruited 2006-2010. Participants were divided into sex-specific quintiles according to 24-hour sodium excretion estimated based on spot samples with the Kawasaki equation. We excluded participants with AF at baseline. Cox regression adjusted for cardiovascular risk factors was used to assess associations with risk of AF, using the third quintile as reference.Results. A total of 257 545 women and 215 535 men were included. During up to 10 years' follow-up, 2221 women and 3751 men were diagnosed with AF. There was a tendency for an increased risk of AF in the lowest and highest quintiles of estimated daily salt intake in both women and men. In the fully adjusted model, significant associations were seen amongst men in the lowest and highest quintiles of sodium excretion (hazard ratio, HR Qv1 , 1.20; 95% CI, 1.08-1.32, P < 0.001, and HR Qv5 1.15, 95% CI, 1.03-1.27, P = 0.011). Conclusion.We found evidence for a U-shaped association between estimated daily salt intake and AF risk amongst men. A suggestive Jshaped association in women was not statistically confirmed, but analyses were likely underpowered. Our results suggest that above a certain physiological minimum level progressively higher salt intake is associated with increasing risk of AF.

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Section: Discussionmentioning

confidence: 99%

Estimated salt intake and risk of atrial fibrillation in a prospective community‐based cohort

et al. 2020

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“…Otherwise, prolonged QTc interval caused atrioventricular dyssynchrony that might aggravate LA remodeling . Atrial effective refractory period (AERP) was suggested as an important determinant of reentry which is a likely fundamental mechanism leading to AF and Nguyen et al . found a positive association between QTc interval and the AERP.…”

Section: Discussionmentioning

confidence: 99%

Prolonged corrected QT interval in predicting atrial fibrillation: A systematic review and meta‐analysis

Zhang

Gong

Tse

et al. 2018

Pacing Clinical Electrophis

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“…The ARIC study examined prolonged QT interval corrected by using the Framingham formula (QTc) as a predictor of incident AF, and showed that prolonged QTc predicts a roughly 2-fold increased risk of AF [25]. QTc interval reflects the atrial effective refractory period (AERP), suggesting that QTc interval may be used as a marker of atrial refractoriness relevant to assessing AF risk and mechanism-specific therapeutic strategies [26]. Hypercapnia has also been implicated in AF occurrence in COPD.…”

Section: Pathophysiological Mechanisms Implicating Chronic Obstructive Pulmonary Disease In Atrial Fibrillationmentioning

confidence: 99%

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Goudis

2017

Journal of Cardiology

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Chronic obstructive pulmonary disease (COPD) is independently associated with atrial fibrillation (AF). Decreased oxygenation, hypercapnia, pulmonary hypertension, diastolic dysfunction, oxidative stress, inflammation, changes in atrial size by altered respiratory physiology, increased arrhythmogenicity from nonpulmonary vein foci commonly located in the right atrium, and respiratory drugs have been implicated in the pathogenesis of AF in COPD. The understanding of the relationship between COPD and AF is of particular importance, as the presence of the arrhythmia has significant impact on mortality, especially in COPD exacerbations. On the other hand, COPD in AF is associated with AF progression, success of cardioversion, recurrence of AF after catheter ablation, and increased cardiovascular and allcause mortality. Treatment of the underlying pulmonary disease and correction of hypoxia and acid-base imbalance represents first-line therapy for COPD patients who develop AF. Cardioselective b-blockers are safe and can be routinely used in COPD. In addition, AF ablation was proved to be efficient and safe, and improves quality of life in these patients. This review presents the association between COPD and AF, describes the pathophysiological mechanisms implicated in AF development in COPD, underlines the prognostic significance of AF in COPD patients and vice versa, and highlights emerging therapeutic approaches in this setting.

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The QT Interval as a Noninvasive Marker of Atrial Refractoriness

Cited by 14 publications

References 26 publications

Estimated salt intake and risk of atrial fibrillation in a prospective community‐based cohort

Estimated salt intake and risk of atrial fibrillation in a prospective community‐based cohort

Prolonged corrected QT interval in predicting atrial fibrillation: A systematic review and meta‐analysis

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

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