AUTOMATIC-MEASUREMENT OF CORRECTED QT INTERVAL IN HOLTER RECORDINGS -COMPARISON OF ITS DYNAMIC BEHAVIOR IN PATIENTS AFTER MYOCARDIAL-INFARCTION WITH AND WITHOUT LIFE-THREATENING ARRHYTHMIAS

This study was designed to determine the value of automatic corrected QT-interval measurement in Holter tapes in patients after myocardial i nfarction as a marker of life-threatening ventricular arrhythmias. We compared the corrected QT interval, automatically measured in 24-hour Halter recordings, in two groups of patients after myocardial infarcti on: group I was composed of 14 patients admitted consecutively to our hospital for documented sustained ventricular tachycardia or out-of-ho spital cardiac arrest. Group II consisted of 28 patients with previous myocardial infarction with characteristics similar to those of group I, but without malignant ventricular arrhythmias in the follow-up. The global mean 24-hour corrected QT interval was longer in group 1 (425 +/- 20 msec) than in those patients after myocardial infarction withou t arrhythmias (group II) (405 +/- 17 msec; p < 0.01). Furthermore, a s ignificant proportion of patients of group I (seven of 14) exhibited m ore peaks of corrected QT longer than 500 msec compared with patients of group II (two of 28; p < 0.005). A circadian rhythm of corrected QT peaks was observed in group I, having a significantly higher incidenc e from 11 PM to 11 AM (p < 0.05). We conclude that automatic corrected QT-interval measurement on Holter electrocardiogram is now available and feasible. Our results suggest that this is a marker for risk asses sment of life-threatening ventricular arrhythmias. Large-scale trials are needed to confirm these results and to determine the predictive va lue of this technique for risk stratification.