Arrhythmias & electrophysiology
TP-fusion at peak exercise: a novel marker for the recognition of unsuspected long QT syndrome patients
Authors' conclusion
TP-fusion, a qualitative trait more easily assessable at peak exercise than QTc prolongation, especially outside referral centres, unmasks a high probability of LQTS, even in subjects with normal baseline QTc.
Study context
- Population
- Healthy athletes and genotype-positive long QT syndrome (LQTS) patients performing a maximal exercise stress test off-therapy64 athletes and 70 patients excluded
- Participants
- 578 participants
- Comparison
- Genotype-positive LQTS patients vs healthy athletes
- LQTSn = 268
- Healthy athletesn = 310reference
- Outcome
- Complete TP-fusion (T and P wave fusion in all precordial leads except V1) at peak exercise
- Follow-up
- Peak exercise
Performance
As reported in the abstract
Prevalence of TP-fusion at peak exercise
P < 0.001
- Appearance of TP-fusion predicted probability of being affected by LQTS
- 88%
Further findings
Prevalence of TP-fusion, subjects below age 25 (subgroup, n = 262)
P < 0.001
- Borderline/normal baseline QTc (<460 ms) among LQTS patients with TP-fusion
- 55% · 24
- Borderline/normal baseline QTc (<460 ms) among LQTS patients with TP-fusion: 44 LQTS patients with TP-fusion
Determinants of TP-fusion
- TP-fusion depends on combination of QTc prolongation and fast heart rates; either alone is not sufficient
Original publication
TP-fusion at peak exercise: a novel marker for the recognition of unsuspected long QT syndrome patients. Europace. Published 16 July 2025. doi:10.
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