Pulmonary vein isolation in a real-world population does not influence QTc interval

AIMS: We aimed to examine whether routine pulmonary vein isolation (PVI) induces significant ventricular repolarization changes as suggested earlier. METHODS AND RESULTS: Five-minute electrocardiograms were recorded at hospital’s admission (T(−1d)), 1 day after the PVI-procedure (T(+1d)) and at 3 months post-procedure (T(+3m)) from a registry of consecutive atrial fibrillation (AF) patients scheduled for routine PVI with different PVI modalities (radiofrequency, cryo-ablation, and hybrid). Only patients who were in sinus rhythm at all three recordings (n = 117) were included. QT-intervals and QT-dispersion were evaluated with custom-made software and QTc was calculated using Bazett’s, Fridericia’s, Framingham’s, and Hodges’ formulas. Both QT- and RR-intervals were significantly shorter at T(+1d) (399 ± 37 and 870 ± 141 ms) and T(+3m) (407 ± 36 and 950 ± 140 ms) compared with baseline (417 ± 36 and 1025 ± 164 ms). There was no statistically significant within-subject difference in QTc Fridericia (T(−1d) 416 ± 28 ms, T(+1d) 419 ± 33 ms, and T(+3m) 414 ± 25 ms) and QT-dispersion (T(−1d) 18 ± 12 ms, T(+1d) 21 ± 19 ms, and T(+3m) 17 ± 12 ms) between the recordings. A multiple linear regression model with age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence to predict the change in QTc at T(+3m) with respect to QTc at T(−1d) did not reach significance which indicates that the change in QTc does not differ between all subgroups (age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence). CONCLUSION: Based on our data a routine PVI does not result in a prolongation of QTc in a real-world population. These findings, therefore, suggest that there is no need to intensify post-PVI QT-interval monitoring.