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QT Dispersion: Much Ado About Something?

Alex Chen, MD; Fred M. Kusumoto, MD
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Affiliations: Albuquerque, NM
 ,  Dr. Chen is a Cardiology Fellow for the Department of Medicine, University of New Mexico. Dr. Kusumoto is Associate Professor of Clinical Medicine, Cardiology Division, Department of Medicine, University of New Mexico, and Director of Electrophysiology and Pacing Service, Cardiology Department, Lovelace Medical Center.

Correspondence to: Fred M. Kusumoto, MD, Electrophysiology and Pacing Service, Cardiology Department, Lovelace Medical Center, 5400 Gibson Blvd SE, Albuquerque, NM 87108; e-mail: fred.kusumoto@lovelacesandia.com



Chest. 2004;125(6):1974-1977. doi:10.1378/chest.125.6.1974
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The QT interval, in its basic form, is a seemingly simple concept. Defined as the interval from the beginning of the QRS complex to the end of the T wave on a surface ECG, the QT interval represents the period of global ventricular depolarization and subsequent repolarization.1 Prolongation of the QT interval due to inherited ion channel abnormalities or due to drugs or metabolic abnormalities has been associated with an increased incidence of ventricular arrhythmias. In addition, experimental studies24 have demonstrated that regional differences in repolarization facilitate reentry and the development of ventricular arrhythmias. Heterogeneous ventricular repolarization was recognized from surface ECGs as early as 1934.5 Over a decade ago, the difference between the longest and shortest QT intervals on a standard 12-lead ECG (QT dispersion) was forwarded as a simply measured marker for vulnerability to ventricular arrhythmias and risk for sudden cardiac death.6 A number of publications followed, and currently there are > 1,000 articles in the literature on QT dispersion. However, the exact physiologic mechanism and true clinical utility of QT dispersion have been the subject of intense debate over the past several years.79

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