title: PQ segment depression in patients with short QT syndrome: a novel marker for diagnosing short QT syndrome?
abstract: BACKGROUND
  Patients with short QT syndrome (SQTS) have an increased risk for atrial tachyarrhythmias, ventricular tachyarrhythmias, and/or sudden cardiac death. PQ segment depression (PQD) is related to atrial fibrillation and carries a poor prognosis in the setting of acute inferior myocardial infarction and is a well-defined electrocardiographic (ECG) marker of acute pericarditis.
  
  
  OBJECTIVE
  To evaluate the prevalence of PQD in SQTS and to analyze the association with atrial arrhythmias.
  
  
  METHODS
  Digitalized 12-lead ECGs of SQTS patients were evaluated for PQD in all leads and for QT intervals in leads II and V5. PQD was defined as ≥0.05 mV (0.5 mm) depression from the isoelectric line.
  
  
  RESULTS
  A total of 760 leads from 64 SQTS patients (mean age 36 ± 18 years; 48 [75%] men) were analyzed. PQD was seen in 265 (35%) leads from 52 (81%) patients and was more frequent in leads II, V3, aVF, V4, and I (n = 43 [67%], n = 30 [47%], n = 27 [42%], n = 25 [39%], and n = 25 [39%], respectively). Nine of 64 (14%) patients presented with atrial tachyarrhythmias, and all of them had PQD.
  
  
  CONCLUSIONS
  Fifty-two of 64 (81%) patients with SQTS reveal PQD. As PQD is rarely observed in healthy individuals, this ECG stigma may constitute a novel marker for SQTS in addition to a short QT interval.
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany. Electronic address: erol.tueluemen@umm.de.
authors.forename: Erol
authors.initials: E
authors.lastname: Tülümen
authors.affiliation: Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Giustetto
authors.affiliation: Department of Medicine-Cardiology, Nephrology and Internal Intensive Care Medicine, Klinikum Ludwigsburg, Ludwigsburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.affiliation: Federation of Cardiology, University Hospital Rangueil, Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
authors.affiliation: Division of Cardiology, Lahti Central Hospital, Lahti, Finland.
authors.forename: Olli
authors.initials: O
authors.lastname: Anttonen
authors.affiliation: Service de Cardiologie, Institut du Thorax, Université de Nantes, Nantes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.affiliation: Departement de Cardiologie, Université de Bretagne Occidentale, Hôpital de la Cavale Blanche, Brest, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Blanc
authors.affiliation: Division of Cardiology, Hôpital Nord, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Sbragia
authors.affiliation: Division of Cardiology, Hôpital Nord, Marseille, France.
authors.forename: Chiara
authors.initials: C
authors.lastname: Scrocco
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Rudic
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Veltmann
authors.affiliation: Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
authors.forename: Yaxun
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Division of Cardiology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Masonic Medical Research Laboratory, Utica, New York.
authors.forename: Charles
authors.initials: C
authors.lastname: Antzelevitch
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.affiliation: University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany; DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schimpf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015716:Electrocardiography, Ambulatory / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D024661:Potassium Channels, Inwardly Rectifying / Q000502:physiology; D011379:Prognosis; D055815:Young Adult
chemical_list: D024661:Potassium Channels, Inwardly Rectifying
keywords: ECG; PQ segment depression; Short QT syndrome; Sudden cardiac death