Meta-analysis of Tpeak-Tend and Tpeak-Tend/QT ratio for risk stratification in congenital long QT syndrome.

ABSTRACT

BACKGROUND AND OBJECTIVES: Congenital long QT syndrome (LQTS) predisposes affected individuals to ventricular tachycardia/fibrillation (VF/VF), potentially resulting in sudden cardiac death. The Tpeak-Tend interval and the Tpeak-Tend/QT ratio, electrocardiographic markers of dispersion of ventricular repolarization, were proposed for risk stratification but their predictive values in LQTS have been controversial. A systematic review and meta-analysis was conducted to examine the value of Tpeak-Tend intervals and Tpeak-Tend/QT ratios in predicting arrhythmic and mortality outcomes in congenital LQTS. METHOD: PubMed and Embase databases were searched until 9th May 2017, identifying 199 studies. RESULTS: Five studies on long QT syndrome were included in the final meta-analysis. Tpeak-Tend intervals were longer (mean difference [MD] 13ms, standard error [SE] 4ms, P=0.002; I2=34%) in congenital LQTS patients with adverse events [syncope, ventricular arrhythmias or sudden cardiac death] compared to LQTS patients without such events. By contrast, Tpeak-Tend/QT ratios were not significantly different between the two groups (MD 0.02, SE 0.02, P=0.26; I2=0%). CONCLUSION: This meta-analysis showed that Tpeak-Tend interval is significant higher in individuals who are at elevated risk of adverse events in congenital LQTS, offering incremental value for risk stratification.