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Short QT Syndrome

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Clinical Cardiogenetics

Abstract

Short QT syndrome is a genetically transmitted disease caused by mutations in different genes that is associated with atrial arrhythmias but more importantly with a severely increased risk of dying suddenly from ventricular tachyarrhythmias. After its first description in the year 2000, there have been increasing reports on patients with different degrees of QT-interval shortening caused by dramatic shortening of repolarization.

In patients at a high risk of sudden death or after aborted sudden death, implantable defibrillator implantation is the therapy of choice. However, quinidine has been proven to be effective in reducing ventricular fibrillation recurrence in patients with frequent shocks and/or in patients who refused defibrillator implantation or were otherwise not suitable for a device.

Ongoing research tries to further elucidate the mechanisms and genetic mutations underlying this life-threatening arrhythmia syndrome.

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References

  1. Gussak I, Brugada P, Brugada J, Wright RS, Kopecky SL, Chaitman BR, et al. Idiopathic short QT interval: a new clinical syndrome? Cardiology. 2000;94:99–102.

    CAS  Google Scholar 

  2. Gaita F, Giustetto C, Bianchi F, Wolpert C, Schimpf R, Riccardi R, et al. Short QT syndrome: a familial cause of sudden death. Circulation. 2003;108:965–70.

    PubMed  Google Scholar 

  3. Bellocq C, van Ginneken AC, Bezzina CR, Alders M, Escande D, Mannens MM, et al. Mutation in the KCNQ1 gene leading to the short QT-interval syndrome. Circulation. 2004;109:2394–7.

    PubMed  Google Scholar 

  4. Priori SG, Pandit SV, Rivolta I, Berenfeld O, Ronchetti E, Dhamoon A, et al. A novel form of short QT syndrome (SQT3) is caused by a mutation in the KCNJ2 gene. Circ Res. 2005;96:800–7.

    CAS  PubMed  Google Scholar 

  5. Antzelevitch C, Pollevick GD, Cordeiro JM, Casis O, Sanguinetti MC, Aizawa Y, et al. Loss-of-function mutations in the cardiac calcium channel underlie a new clinical entity characterized by ST-segment elevation, short QT intervals, and sudden cardiac death. Circulation. 2007;115:442–9.

    PubMed  PubMed Central  Google Scholar 

  6. Hong K, Piper DR, Diaz-Valdecantos A, Brugada J, Oliva A, Burashnikov E, et al. De novo KCNQ1 mutation responsible for atrial fibrillation and short QT syndrome in utero. Cardiovasc Res. 2005;68:433–40.

    CAS  PubMed  Google Scholar 

  7. Brugada R, Hong K, Dumaine R, Cordeiro J, Gaita F, Borggrefe M, et al. Sudden death associated with short-QT syndrome linked to mutations in HERG. Circulation. 2004;109:30–5.

    CAS  PubMed  Google Scholar 

  8. El Harchi A, Melgari D, Zhang YH, Zhang H, Hancox C. Action potential clamp and pharmacology of the variant 1 short QT syndrome T618I hERG K+ channel. PLoS One. 2012;7:e52451.

    PubMed  PubMed Central  Google Scholar 

  9. Moreno C, Olivera A, de la Cruz A, Bartolucci C, Mun C, Salar E, et al. A new KCNQ1 mutation at the S5 segment that impairs its association with KCNE1 is responsible for short QT syndrome. Cardiovasc Res. 2015;107:613–23.

    CAS  PubMed  Google Scholar 

  10. Giustetto C, Di Monte F, Wolpert C, Borggrefe M, Schimpf R, Sbragia P, et al. Short QT syndrome: clinical findings and diagnostic-therapeutic implications. Eur Heart J. 2006;27:2440–7.

    PubMed  Google Scholar 

  11. Mazzanti A, Kanthan A, Monteforte N, Memmi M, Bloise R, Novelli V, et al. Novel insight into the natural history of short QT syndrome. J Am Coll Cardiol. 2014;63:1300–8.

    PubMed  PubMed Central  Google Scholar 

  12. Villafane J, Atalla J, Gollob M, Maury P, Wolpert C, Gebauer R, et al. Long-term follow-up of a pediatric cohort with short QT syndrome. J Am Coll Cardiol. 2013;61:1183–91.

    PubMed  Google Scholar 

  13. Villafane J, Fischbach P, Gebauer R. Short QT syndrome manifesting with neonatal atrial fibrillation and bradycardia. Cardiology. 2014;128:236–40.

    PubMed  Google Scholar 

  14. Gollob MH, Redpath CJ, Roberts JD. The short QT syndrome. JACC. 2011;57:802–12.

    PubMed  Google Scholar 

  15. Harrell DT, Ashihara T, Ishikawa T, Tominaga I, Mazzanti A, Takahashi K, et al. Genotype-dependent differences in age of manifestation and arrhythmia complications in short QT syndrome. Int J Cardiol. 2015;190:393–402.

    PubMed  Google Scholar 

  16. Fukuyama M, Ohno S, Wang W, Kimura H, Makivama T, Itoh H, et al. L-type calcium channel mutations in Japanese patients. With inherited arrhythmias. Circ J. 2013;77:1799–806.

    CAS  PubMed  Google Scholar 

  17. Hu D, Li Y, Zhang J, Pfeiffer R, Gollob MH, Healey J, et al. The phenotypic spectrum of a mutation hotspot responsible for the short QT syndrome. JACC. 2017;3:727–4l.

    PubMed  Google Scholar 

  18. Anttonen O, Junttila MJ, Rissanen H, Reunanen A, Viitasalo M, Huikuri HV. Prevalence and prognostic significance of short QT interval in a middle-aged Finnish population. Circulation. 2007;116:714–20.

    CAS  PubMed  Google Scholar 

  19. Funada A, Hayashi K, Ino H, Fujino N, Uchiyama K, Sakata K, et al. Assessment of QT intervals and prevalence of short QT syndrome in Japan. Clin Cardiol. 2008;31:270–4.

    PubMed  PubMed Central  Google Scholar 

  20. Gallagher MM, Magliano G, Yap YG, Padula M, Morgia V, Postorino C, et al. Distribution and prognostic significance of QT intervals in the lowest half centile in 12,012 apparently healthy persons. Am J Cardiol. 2006;98:933–5.

    PubMed  Google Scholar 

  21. Kobza R, Roos M, Niggli B, Abacherli R, Lupi GA, Frey F, et al. Prevalence of long and short QT in a young population of 41,767 predominantly male Swiss conscripts. Heart Rhythm. 2009;6:652–7.

    PubMed  Google Scholar 

  22. Viskin S. The QT interval: too long, too short or just right. Heart Rhythm. 2009;6:711–5.

    PubMed  Google Scholar 

  23. Iribarren C, Round AD, Peng J, Lu M, Klatzsky AL, Zaroff JG, et al. Short QT in a cohort of 1.7 million persons: prevalence, correlates, and prognosis. Ann Noninvasive Electrocardiol. 2014;19:490–500.

    PubMed  PubMed Central  Google Scholar 

  24. Portugal G, Olivera MM, Cunha P, Ferreira F, Lousinha A, Fiarresga A, et al. Short QT syndrome presenting as syncope: how short is too short? Rev Port Cardiol. 2014;33:649.e1–6.

    Google Scholar 

  25. Postema PG, Wilde AMM. The measurement of the QT interval. Curr Cardiol Rev. 2014;10:287–94.

    PubMed  PubMed Central  Google Scholar 

  26. Anttonen O, Junttila MJ, Maury P, Schimpf R, Wolpert C, Borggrefe M, et al. Differences in twelve-lead electrocardiogram between symptomatic and asymptomatic subjects with short QT interval. Heart Rhythm. 2009;6:267–71.

    PubMed  Google Scholar 

  27. Giustetto C, Scorocco C, Schimpf R, Maury P, Mazzanti A, Levetto M, et al. Usefulness of exercise test in the diagnosis of short QT syndrome. Europace. 2015;17:628–34.

    PubMed  Google Scholar 

  28. Tülümen E, Giustetto C, Wolpert C, Maury P, Anttonen O, Probst V, et al. PQ segment depression in patients with short QT syndrome: a novel marker for diagnosing short QT syndrome? Heart Rhythm. 2014;11:1024–30.

    PubMed  PubMed Central  Google Scholar 

  29. Schimpf R, Antzelevitch C, Haghi D, Giustetto C, Pizzuti A, Gaita F, et al. Electromechanical coupling in patients with the short QT syndrome: further insights into the mechanoelectrical hypothesis of the U wave. Heart Rhythm. 2008;5:241–5.

    PubMed  Google Scholar 

  30. Frea S, Giustetto C, Capriolo M, Scrocco C, Fornengo C, Benedetto S, et al. New echocardiographic insights in short QT syndrome: more than a channelopathy? Heart Rhythm. 2015;12:2096–105.

    PubMed  Google Scholar 

  31. Wolpert C, Schimpf R, Giustetto C, Antzelevitch C, Cordeiro J, Dumaine R, et al. Further insights into the effect of quinidine in short QT syndrome caused by a mutation in HERG. J Cardiovasc Electrophysiol. 2005;16:54–8.

    PubMed  PubMed Central  Google Scholar 

  32. Rollin A, Gandjbakhch E, Giustetto C, Scrocco C, Fourcade C, Monteil B. Shortening of the short refractory periods in short QT syndrome. J Am Heart Assoc. 2017;6:e005684.

    PubMed  PubMed Central  Google Scholar 

  33. Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, et al. ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2015;36:2793–867.

    Google Scholar 

  34. Deo M, Ruan Y, Pandit SV, Shah K, Berenfeld O, Blaufox A, Cerrone M, et al. KCNJ2 mutation in short QT syndrome 3 results in atrial fibrillation and ventricular proarrhythmia. Proc Natl Acad Sci U S A. 2013;110:4291–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Akdis D, Saguner AM, Medeiros-Domingo A, Schaller A, Balmer C, Steffel J, et al. Multiple clinical profiles of families with the short QT syndrom. Europace. 2018;20:f113–21.

    CAS  PubMed  Google Scholar 

  36. Suzuki H, Hoshina S, Ozawa J, Sato A, Minamino T, Aizawas Y. Short QT syndrome in a boy diagnosed on screening for heart disease. Pediatr Int. 2014;56:775–6.

    Google Scholar 

  37. Roussel J, Labarthe F, Thireau J, Ferro F, Farah C, Roy J, et al. Carnitine deficiency induces a short QT syndrome. Heart Rhythm. 2016;13:165–74.

    PubMed  Google Scholar 

  38. Thorsen K, Dam VS, Kjaer-Sorensen K, Pedersen LN, Skeberdis VA, Jurevicius J. Loss-of-activity-mutation in the cardiac chloride-bicarbonate exchanger AE3 causes short QT syndrome. Nat Commun. 2017;1:1696.

    Google Scholar 

  39. Extramiana F, Antzelevitch C. Amplified transmural dispersion of repolarization as the basis for arrhythmogenesis in a canine ventricular-wedge model of short-QT syndrome. Circulation. 2004;110:3661–6.

    PubMed  Google Scholar 

  40. Milberg P, Tegelkamp R, Osada N, Schimpf R, Wolpert C, Breithardt G, et al. Reduction of dispersion of repolarization and prolongation of postrepolarization refractoriness explain the antiarrhythmic effects of quinidine in a model of short QT syndrome. J Cardiovasc Electrophysiol. 2007;18:658–64.

    PubMed  Google Scholar 

  41. Schimpf R, Bauersfeld U, Gaita F, Wolpert C. Short QT syndrome: successful prevention of sudden cardiac death in an adolescent by implantable cardioverter-defibrillator treatment for primary prophylaxis. Heart Rhythm. 2005;2:416–7.

    PubMed  Google Scholar 

  42. Giustetto C, Schimpf R, Mazzanti A, Scorocco S, Maury P, Anttonen O, et al. Long-term follow-up of patients with short QT syndrome. JACC. 2011;58:587–95.

    PubMed  Google Scholar 

  43. Meijer van Putten R, Mengarelli I, Guan K, Zegers JG, ACG v G, Verkerk AO. Ion channelopathies in human induced pluripotent stem cell derived cardiomyocytes: a dynamic clamp study with virtual IK1. Frontiers Physiol. 2015;6:1–18.

    Google Scholar 

  44. El-Battrawy I, Lan H, Cyganek L, Zhao Z, Li X, Bulubasic F, et al. Modeling short QT syndrome using human-induced pluripotent stem cell-derived cardiomyocytes. J Am Heart Assoc. 2018;7:e007394.

    PubMed  PubMed Central  Google Scholar 

  45. McPate MJ, Zhang H, Adeniran I, Cordeiro JM, Witchel HJ, Hancox JC. Comparative effects of the short QT N588K mutation at 37 degrees C on hERG K+ channel current during ventricular, Purkinje fibre and atrial action potentials: an action potential clamp study. J Physiol Pharmacol. 2009;60:23–41.

    CAS  PubMed  Google Scholar 

  46. Cordeiro JM, Brugada R, Wu YS, Hong K, Dumaine R. Modulation of I(Kr) inactivation by mutation N588K in KCNH2: a link to arrhythmogenesis in short QT syndrome. Cardiovasc Res. 2005;67:498–509.

    CAS  PubMed  Google Scholar 

  47. Gaita F, Giustetto C, Bianchi F, Schimpf R, Haissaguerre M, Calo L, et al. Short QT syndrome: pharmacological treatment. J Am Coll Cardiol. 2004;43:1494–9.

    CAS  PubMed  Google Scholar 

  48. Frommeyer G, Weller J, Ellermann C, Kaese S, Kochhaeuser S, Lange PS. Antiarrhythmic properties of ivabradine in an experimental model of short-QT-syndrome. Clin Exp Pharmacol Physiol. 2017;44:941–94.

    CAS  PubMed  Google Scholar 

  49. Frommeyer G, Ellermann C, Dechering D, Kochhaeuser S, Boegeholz N, Guener F, et al. Ranolazine and Vernakalant prevent ventricular arrhythmias in an experimental whole-heart model of short-QT-syndrome. J Cardiovasc Electrophysiol. 2016;27:1214–9.

    PubMed  Google Scholar 

  50. Mazzanti A, Maragna R, Vacanti G, Kostopoulou A, Marino M, Monteforte N, et al. Hydroquinidine prevents life-threatening in patient with short QT syndrome. JACC. 2017;24:3010–5.

    Google Scholar 

  51. Schimpf R, Wolpert C, Bianchi F, Giustetto C, Gaita F, Bauersfeld U, et al. Congenital short QT syndrome and implantable cardioverter defibrillator treatment: inherent risk for inappropriate shock delivery. J Cardiovasc Electrophysiol. 2003;14:1273–7.

    PubMed  Google Scholar 

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Wolpert, C., Schulze-Bahr, E. (2020). Short QT Syndrome. In: Baars, H.F., Doevendans, P.A.F.M., Houweling, A.C., van Tintelen, J.P. (eds) Clinical Cardiogenetics. Springer, Cham. https://doi.org/10.1007/978-3-030-45457-9_13

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  • DOI: https://doi.org/10.1007/978-3-030-45457-9_13

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