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Europace 2000 2(1):20-31; doi:10.1053/eupc.1999.0068
© 2000 by European Society of Cardiology
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Comparison of QT dispersion during atrial fibrillation and sinus rhythm in the same patients, at normal and prolonged ventricular repolarization

B. Houltz, B. Darpö1, K. Swedberg, P. Blomström2, H.J.G.M. Crijns3, S.M. Jensen4, E. Svernhage5 and N. Edvardsson6

Department of Medicine, Sahlgrenska University Hospital, Östra Göteborg, Sweden; 1Department of Cardiology, Karolinska Hospital Stockholm, Sweden; 2Department of Cardiology, Uppsala University Hospital Uppsala, Sweden; 3Department of Cardiology, University Hospital Groningen, The Netherlands; 4Department of Cardiology, Umeå University Hospital Umeå, Sweden; 5Astra-Hässle AB Mölndal, Sweden; 6Division of Cardiology, Sahlgrenska University Hospital, Sahlgrenska Göteborg, Sweden

AIMS: Drug-induced increase in QT dispersion has been associated with increased risk of ventricular proarrhythmia. The aim of the present study was to compare QT dispersion during atrial fibrillation and sinus rhythm in the same patients at normal and prolonged ventricular repolarization.

METHODS AND RESULTS: Sixty-one patients who had had chronic atrial fibrillation for 8±14 months received a 6 h infusion of the Ikr-blocker almokalant, the first 90 min of which are used for this analysis. The following day, after conversion to sinus rhythm, by almokalant (n=19) or direct current cardioversion (n=42), an identical 90 min infusion was administered. Prior to infusion, there was no difference in precordial QT dispersion between atrial fibrillation and sinus rhythm (29±12 vs 36±17 ms, P=ns). During infusion, at prolonged repolarization, the increase in QT dispersion was greater during sinus rhythm than during atrial fibrillation (58±49 vs 30±15 ms,P =0·0011, after 30 min infusion). No correlation was found between QT dispersion and the QT or RR interval.

CONCLUSION: QT dispersion during atrial fibrillation does not differ from QT dispersion during sinus rhythm during normal repolarization, while measurement of QT dispersion during prolonged repolarization, induced by an Ikr-blocker, yielded larger values during sinus rhythm than during atrial fibrillation.

Key Words: QT dispersion, ventricular repolarization, class III antiarrhythmic agent, atrial fibrillation, sinus rhythm, almokalant

Correspondence: Dr Birgitta Houltz, Department of Clinical Physiology, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden.


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