Acquired long QT syndrome in hospitalized patients.
Acquired long QT syndrome (ALQTS) has long been overlooked in clinical practice. Recent studies reported that severe ALQTS (QTc ≥500 ms) in hospitalized patients is associated with increased all-cause mortality.



The purpose of this study was to determine the role of ALQTS in the clinical outcomes of hospitalized patients.



Electronic medical records were reviewed to identify severe ALQTS in hospitalized patients in a single study center from September 1, 2013, to February 28, 2014. Up to 1-year follow-up was conducted in the ALQTS subjects and compared with age-, gender-, and admitting diagnosis-matched hospitalized patients with a normal QT interval.



Severe ALQTS (QTc 529 ± 38 ms) was seen in 0.7% (293/41,649) of hospitalized patients, of whom 86% were treated in noncardiology departments. All-cause mortality was 32% in the ALQTS group vs 14% in the control group (P <.001) during follow-up of 255 ± 63 days. Syncope and life-threatening ventricular arrhythmia were more frequent in patients with severe ALQTS (6% vs 0.6%, P <.0001). Cerebral hemorrhage (odds ratio [OR] 6.405, 95% confidence interval [CI] 2.341-17.525), cancer (OR 5.937, 95% CI 2.658-13.260), infection (OR 2.207, 95% CI 1.124-4.333), and end-stage disease (OR 2.092, 95% CI 1.045-4.191) are the major contributors to all-cause mortality in ALQTS.



Severe ALQTS is not uncommon in hospitalized patients. It can be easily overlooked because the majority of patients with severe ALQTS are treated in noncardiology departments. The clinical outcome of severe ALQTS is poor. Removing QT-prolonging factors may reduce the risks of fatal arrhythmia and sudden death in patients with ALQTS.
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Haixu
H
Yu
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; Lankenau Medical Center and Lankenau Institute for Medical Research, Jefferson Medical College, Philadelphia, Pennsylvania. Electronic address: ldlzhang@gmail.com.
Li
L
Zhang
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Jinqiu
J
Liu
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Ying
Y
Liu
Lankenau Medical Center and Lankenau Institute for Medical Research, Jefferson Medical College, Philadelphia, Pennsylvania.
Peter R
PR
Kowey
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Yanli
Y
Zhang
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Yue
Y
Chen
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Yushan
Y
Wei
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Lianjun
L
Gao
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Huihua
H
Li
Beijing AnZhen Hospital, Capital Medical University, the Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Jie
J
Du
Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. Electronic address: yunlong_xia@126.com.
Yunlong
Y
Xia
D000368:Aged; D002681:China / Q000453:epidemiology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D003951:Diagnostic Errors / Q000517:prevention & control*; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
Acquired long QT syndrome; All-cause mortality; Ventricular arrhythmia