Refereed journal article or data article (A1)

Risk of sudden cardiac death associated with QRS, QTc, and JTc intervals in the general population

List of Authors: Tikkanen Jani T., Kentta Tuomas, Porthan Kimmo, Anttonen Olli, Eranti Antti, Aro Aapo L., Kerola Tuomas, Rissanen Harri A., Knekt Paul, Heliövaara Markku, Holkeri Arttu, Haukilahti Anette, Niiranen Teemu, Hernesniemi Jussi, Jula Antti, Nieminen Markku S., Myerburg Robert J., Albert Christine M., Salomaa Veikko, Huikuri Heikki V., Junttila M. Juhani

Publisher: Elsevier B.V.

Publication year: 2022

Journal: Heart Rhythm

Journal name in source: Heart Rhythm

eISSN: 1556-3871



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QRS duration and corrected QT (QTc) interval have been associated with sudden cardiac death (SCD), but no data are available on the significance of repolarization component (JTc interval) of the QTc interval as an independent risk marker in the general population.

In this study, we sought to quantify the risk of SCD associated with QRS, QTc, and JTc intervals.

This study was conducted using data from 3 population cohorts from different eras, comprising a total of 20,058 individuals. The follow-up period was limited to 10 years and age at baseline to 30–61 years. QRS duration and QT interval (Bazett’s) were measured from standard 12-lead electrocardiograms at baseline. JTc interval was defined as QTc interval – QRS duration. Cox proportional hazards models that controlled for confounding clinical factors identified at baseline were used to estimate the relative risk of SCD.

During a mean period of 9.7 years, 207 SCDs occurred (1.1 per 1000 person-years). QRS duration was associated with a significantly increased risk of SCD in each cohort (pooled hazard ratio [HR] 1.030 per 1-ms increase; 95% confidence interval [CI] 1.017–1.043). The QTc interval had borderline to significant associations with SCD and varied among cohorts (pooled HR 1.007; 95% CI 1.001–1.012). JTc interval as a continuous variable was not associated with SCD (pooled HR 1.001; 95% CI 0.996–1.007).

Prolonged QRS durations and QTc intervals are associated with an increased risk of SCD. However, when the QTc interval is deconstructed into QRS and JTc intervals, the repolarization component (JTc) appears to have no independent prognostic value.

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Last updated on 2022-28-09 at 12:59