Arrhythmias & electrophysiologyCohort study

An International Multicenter Evaluation of Type 5 Long QT Syndrome

CirculationPublished

  • Multicentre cohort study
  • international
  • 22 genetic arrhythmia clinics and 4 registries from 9 countries

Authors' conclusion

The present study suggests that putative/confirmed loss-of-function KCNE1 variants predispose to QT prolongation, however, the low ECG penetrance observed suggests they do not manifest clinically in the majority of individuals, aligning with the mild phenotype observed for Type 2 Jervell and Lange-Nielsen syndrome patients.

Study context

Population
Patients with rare KCNE1 variants: presumed autosomal dominant LQT5 or recessive Type 2 Jervell and Lange-Nielsen syndrome32 distinct KCNE1 variants
Participants
89 / 140 / 19
Exposure
Probands vs Family members vs Type 2 Jervell and Lange-Nielsen syndrome
  • Probandsn = 89
  • Family membersn = 140reference
  • Type 2 Jervell and Lange-Nielsen syndromen = 19
Outcome
Definite arrhythmic events:
  • Appropriate ICD shocks
  • Aborted cardiac arrest
  • SCD

Main finding

As reported in the abstract

Definite arrhythmic events
Estimate (95% CI)P value
Probands vs Family members
adjusted HR 11.6(2.6–52.2)
P = 0.001
Type 2 JLNS vs overall heterozygous cohortdid not differ significantly
HR 1.7(0.3–10.8)
P = 0.590

Observational data: associations, not effects.

Further findings

Mean, ms

OutcomeProbandsFamily membersType 2 Jervell and Lange-Nielsen syndromeP value
QTc on presenting ECG (presumed LQT5)476.9 (SD 38.6)441.8 (SD 30.9)Not reported in the abstractP < 0.001
ECG penetrance (QTc >460 ms), heterozygous family members
20.7% · 29 of 140

Cumulative prevalence of the 32 KCNE1 variants in gnomAD vs anticipated LQT5 prevalence

238-fold greater (0.238% vs 0.001%)

Original publication

An International Multicenter Evaluation of Type 5 Long QT Syndrome. Circulation. Published 16 January 2020. doi:10.1161/circulationaha.119.043114

Summarised from the published abstract; every number is checked against it