Association between QT dispersion and ventricular ectopic beat burden in patients without structural heart disease
Abstract
Aims: Ventricular ectopic beats (VEB) are among the most frequently encountered rhythm abnormalities in clinical practice. Although generally considered benign, increased VE burden may indicate underlying electrophysiological instability. QT dispersion (QTd), a non-invasive electrocardiographic marker reflecting regional heterogeneity of ventricular repolarization, has been suggested as a predictor of ventricular arrhythmias. This study aimed to investigate the association between corrected QTd and VEB burden.
Methods: This retrospective cross-sectional study included adult patients (≥18 years) who presented with palpitations between July 2023 and July 2025 and underwent both a standard 12-lead ECG and a 24-hour Holter ECG recording. Individuals with structural heart disease, coronary artery disease, arrhythmic medications, or reduced EF (<50%) were excluded. The final analysis included 301 patients, divided into two groups: frequent VEBs (≥100 in 24 hours, n=212) and infrequent VEBs (<100, n=89). QT intervals were measured manually, and QTd_corrected was calculated as the difference between maximum and minimum QT intervals values using Bazett’s formula. Clinical, biochemical, and echocardiographic parameters were retrospectively collected. Comparative analyses and linear regression were performed to evaluate predictors of VEB count. Additionally, ROC analysis was used to identify the optimal QTd_corrected cut-off.
Results: The QTd_corrected was significantly higher in the frequent VEB group compared to the infrequent group (65.79 ± 14.85 ms vs. 60.88 ± 14.98 ms, p=0.009). In multivariate linear regression, QTd_corrected was found to be an independent predictor of VEB count (β=0.200, p<0.001). ROC analysis revealed that a QTd_corrected value >62 ms predicted high VEB burden with 71% sensitivity and 70% specificity (AUC = 0.734, 95% CI: 0.670–0.798).
Conclusion: QTd_corrected was significantly and independently associated with VEB frequency in this cohort. This finding suggests that QTd_corrected may serve as a practical and non-invasive tool to estimate arrhythmic burden, especially in patients without structural heart disease.
Keywords
References
- 1. Lee A, Walters TE, Gerstenfeld EP, Haqqani HM. Frequent ventricular ectopy: implications and outcomes. Heart Lung Circ. 2019;28(1):178-190. doi: 10.1016/j.hlc.2018.09.009
- 2. AlMahameed ST, Ziv O. Ventricular arrhythmias. Med Clin North Am. 2019;103(5):881-895. doi: 10.1016/j.mcna.2019.05.008
- 3. Graham AJ, Orini M, Zacur E, Dhillon G, Daw H, Srinivasan NT, et al. Evaluation of ECG imaging to map hemodynamically stable and unstable ventricular arrhythmias. Circ Arrhythm Electrophysiol. 2020;13(2):e007377. doi: 10.1161/CIRCEP.119.007377
- 4. Bazoukis G, Yeung C, Ho RWH, Varrias D, Papadatos S, Lee S, et al. Association of QT dispersion with mortality and arrhythmic events: a meta-analysis of observational studies. J Arrhythm. 2020;36(1):105-115. doi: 10.1002/joa3.12253
- 5. Malik M, Batchvarov VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol. 2000;36(6):1749-1766. doi: 10.1016/s0735-1097(00)00962-1
- 6. Kosmopoulos M, Roukoz H, Sebastian P, Kalra R, Goslar T, Bartos JA, et al. Increased QT dispersion is linked to worse outcomes in patients hospitalised for out-of-hospital cardiac arrest. J Am Heart Assoc. 2020;9(16):e016485. doi: 10.1161/JAHA.120.016485
- 7. Kautzner J, Malik M. QT interval dispersion and its clinical utility. Pacing Clin Electrophysiol. 1997;20(10):2625-2640. doi: 10.1111/j.1540-8159.1997.tb06112.x
- 8. Pye M, Quinn A, Cobbe S. QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Heart. 1994;71(6):511-514. doi: 10.1136/hrt.71.6.511
Details
Primary Language
English
Subjects
Cardiology
Journal Section
Research Article
Authors
Özden Seçkin
0000-0001-7385-4419
Türkiye
Mustafa Candemir
0000-0002-3645-3912
Türkiye
Serkan Ünlü
0000-0001-6179-8579
Türkiye
Publication Date
March 12, 2026
Submission Date
July 14, 2025
Acceptance Date
August 26, 2025
Published in Issue
Year 2026 Volume: 6 Number: 1