HRJ: QT and heart rate variance predict gender-specific risk of VT/VF

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Increased QT variability is an independent predictor of ventricular tachycardia or ventricular fibrillation in men, while in women, QT variability alone does not pose a risk of arrhythmic events, according to a study in the February edition of the Heart Rhythm Journal.

The study confirms that gender plays a significant role in predicting the risk of ventricular tachycardia (VT) or ventricular fibrillation (VF). In addition, researchers found that QT variability, when not correlated to heart rate variability, is a uniquely significant predictor of arrhythmic events in women.

The study, led by Mark C. P. Haigney, MD, from the division of cardiology at Uniformed Services University of the Health Sciences in Maryland, derived a patient population from those enrolled in the Multicenter Automatic Defibrillator Trial (MADIT) II.

From the MADIT II patient population of 1,232, there were 805 usable recordings of QT and heart rate identified—663 men and 142 women. During a follow-up period averaging 2.6 years, study analysis found increase QT variability or heart rate variance was associated with a significantly higher risk of VT/VF in men, but not in women. While reduced coherence, QT variability dissociated from heart rate variability, predicted VT/VF in women, reduced coherence was not predictive in men.

“While it is well-established that gender plays a role in the incidence of arrhythmic events, our study attempted to identify the specific predictors of VT/VF and how they vary in men and women,” said Haigney. “Our findings confirm that different measures of variability in QT and heart rate determine the level of risk for men and women and we hope that eventually these measures may be used to test exactly who is at risk of VT/VF.”

The results of this study identify two types of measures of variability that appear to have different prognostic value depending on the gender of the patient – QT variability for men and low coherence in women. Therefore, measuring variance in QT and heart rate may allow for a better prediction of which patients are at risk of VT/VF and will benefit from implantable cardioverter defibrillator (ICD) therapy, researchers concluded.