title: Use of QT intervals for a more accurate diagnose of syncope and evaluation of syncope severity.
abstract: BACKGROUND
  This study aimed to evaluate the use of QT intervals, their diagnostic predictive value in patients with syncope and their relationship with syncope severity.
  
  
  METHODS
  One hundred and forty nine patients with a diagnosis of syncope were admitted to Internal Medicine departments at the University of Palermo, Italy, between 2006 and 2012, and 140 control subjects hospitalised for other causes were enrolled. QT maximum, QT minimum, QTpeak, QT corrected, QT dispersion and Tpeak-to-Tend interval were compared between two groups. The paper medical records were used for scoring with San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in SYncope Study (EGSYS) score and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score.
  
  
  RESULTS
  Mean QTc (p < 0.0005), mean QTmax (p < 0.0005), mean QTdisp (p < 0.0005), mean QTpeak (p = 0.005) and mean TpTe (p = 0.018) were significantly longer in patients with syncope compared with control subjects. A QTc > 424.8 ms (sensibility: 81.88 - specificity: 57.86) showed the greatest predictive value for diagnosis of syncope. On the EGSYS score and on the OESIL score, QTc was significantly prolonged in high-risk patients compared with low-risk patients. On the San Francisco Syncope Rule, QTc and QTdisp were significantly prolonged in high-risk patients compared with low-risk patients.
  
  
  CONCLUSIONS
  Mean QTc, mean QTdisp, mean TpTe, mean QTmax and mean QTpeak were significantly longer in patients with syncope compared with control subjects. Furthermore, prolonged QTc and QTdisp were associated with major severe syncope according to San Francisco Syncope Rule, EGSYS and OESIL risk scores.
authors.affiliation: U.O.C. Medicina Vascolare, Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di, Palermo, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Buttà
authors.forename: A
authors.initials: A
authors.lastname: Tuttolomondo
authors.forename: A
authors.initials: A
authors.lastname: Casuccio
authors.forename: D
authors.initials: D
authors.lastname: Di Raimondo
authors.forename: L
authors.initials: L
authors.lastname: Giarrusso
authors.forename: G
authors.initials: G
authors.lastname: Miceli
authors.forename: S
authors.initials: S
authors.lastname: Lo Vecchio
authors.forename: B
authors.initials: B
authors.lastname: Canino
authors.forename: G
authors.initials: G
authors.lastname: Licata
authors.forename: A
authors.initials: A
authors.lastname: Pinto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology