QT Dispersion Is Not associated with Sudden Cardiac Death or Mortality in Heart Transplant Recipients


  • Gregory M. Marcus
  • Khanh L. Hoang
  • Sharon A. Hunt
  • Sung H. Chun
  • Byron K. Lee




Background: Sudden cardiac death (SCD) has been shown to be a significant cause of death after heart transplantation. QT dispersion (QTd) is associated with SCD in several highrisk populations. We hypothesized that QTd would predict mortality and SCD in heart transplantation patients.

Methods: We examined the clinical charts and most recent electrocardiograms (ECGs) for patients who received heart transplants at Stanford University Medical Center during the period 1981-1995. QTd was measured with all 12 leads and the precordial leads. Analysis was performed by a single reader blinded to patient outcomes.

Results: A total of 346 patients who had undergone transplantation had available ECGs and known outcomes; 155 of these patients died, and 42 of these deaths were attributed to SCD. The 12-lead mean QTd was not significantly different between outcome groups: patients who survived had a 12-lead mean QTd of 58 ± 29 milliseconds and those who died had a 12-lead mean QTd of 61 ± 32 milliseconds (P = .57). Patients who died from SCD had a 12-lead mean QTd of 57 ± 31 milliseconds (P = .40), and those who died of other causes had a 12-lead mean QTd of 59 ± 34 milliseconds (P = .36 vs those who died of SCD). Similarly, the precordiallead mean QTd did not differ significantly between the different outcome groups.

Conclusions: We found no correlation between QTd and SCD or mortality in heart transplant recipients. Until additional studies prove a positive association, QTd should not be used as a prognostic marker in these patients.


Ali A, Mehra MR, Malik FS, Uber PA, Ventura HO. 2001. Insights into ventricular repolarization abnormalities in cardiac allograft vasculopathy. Am J Cardiol87:367-8, A10.nBrendorp B, Elming H, Jun L, et al. 2001. QT dispersion has no prognostic information for patients with advanced congestive heart failure and reduced left ventricular systolic function. Circulation103:831-5.nDubin AM, Rosenthal DN, Chin C, Bernstein D. 1999. QT dispersion predicts ventricular arrhythmia in pediatric cardiomyopathy patients referred for heart transplantation. J Heart Lung Transplant18:781-5.nGalinier M, Vialette JC, Fourcade J, et al. 1998. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J19:1054-62.nHunt S. 2001. Reinnervation of the transplanted heart: why is it important? N Engl J Med345:762-4.nLee KW, Kligfield P, Dower GE, Okin PM. 2001. QT Dispersion, T-wave projection, and heterogeneity of repolarization in patients with cornary artery disease. Am J Cardiol87:148-151.nMalik M, Batchvarov VN. 2000. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol36:1749-66.nMarcus GM, Hoang KL, Hunt SA, Chun SH, Lee BK. Prevalence, patterns of development, and prognosis of right bundle branch block in heart transplant recipients. Am J Cardiol 2006;98:1288-90.nPatel VS, Lim M, Massin EK, et al. 1996. Sudden cardiac death in cardiac transplant recipients. Circulation94:II273-7.nSomberg JC, Molnar J. 2002. Usefulness of QT dispersion as an electrocardiographically derived index. Am J Cardiol89:291-4.nStatters DJ, Malik M, Ward DE, Camm AJ. 1994. QT dispersion: problems of methodology and clinical significance. J Cardiovasc Electrophysiol5:672-85.nSurawicz B. 1996. Will QT dispersion play a role in clinical decision-making? J Cardiovasc Electrophysiol7:777-84.nVassilikos VP, Karagounis LA, Psichogios A, et al. 2001. Correction for heart rate is not necessary for QT dispersion in individuals without structural heart disease and patients with ventricular tachycardia. Ann Noninvasive Electrocardiol7:47-52.n



How to Cite

Marcus, G. M., Hoang, K. L., Hunt, S. A., Chun, S. H., & Lee, B. K. (2008). QT Dispersion Is Not associated with Sudden Cardiac Death or Mortality in Heart Transplant Recipients. The Heart Surgery Forum, 11(5), E281-E284. https://doi.org/10.1532/HSF98.20081023