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KMID : 1011920200210010009
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International Journal of Arrhythmia
2020 Volume.21 No. 1 p.9 ~ p.9
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Clinical and genetic relationships between the QTc interval and risk of a stroke among atrial fibrillation patients undergoing catheter ablation
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Hong Myung-Hee
Chun Kyeong-Hyeon
Hwang In-Seok
Yu Hee-Tae
Kim Tae-Hoon
Uhm Jae-Sun
Joung Bo-Young
Lee Moon-Hyoung
Pak Hui-Nam
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Abstract
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Background and objectives: A prolonged QTc interval is associated with an increased risk of a stroke or atrial fibrillation (AF). However, its direct causal relationship with AF associated a stroke has not been proven yet. To examine whether QTc interval is causally linked with risk of stroke in AF patients, we used the Mendelian randomization analysis.
Subjects and methods: Among 2742 patients (73.6% male; 58.2?±?11.0 years old; 69.5% with paroxysmal AF) who underwent AF catheter ablation, we analyzed 1766 patients who had preablation sinus rhythm electrocardiograms off antiarrhythmic drugs after excluding amiodarone users. Among them, 1213 subjects had genome-wide association study dataset analyzable for the Mendelian randomization. We explored the mechanistic relationships between QTc interval (ms) and the risk of a stroke by analyzing the Mendelian randomization (1213 subjects) after reviewing 35 genetic polymorphisms associated with the QTc in 31 European descent studies.
Results: Among the patients in the higher quartile with a higher QTc, CHA2DS2-VASc score (p?
Conclusion: The QTc was independently associated with the CHA2DS2-VASc score and strokes among the patients with AF who underwent catheter ablation, despite no genetically direct causal relationship.
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KEYWORD
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Atrial fibrillation, QT interval, Stroke, Mendelian randomization analysis
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