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The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Associate Professor Morten Salling Olesen, Rigshospitalet, Copenhagen, Denmark
- Second opponent: Associate Professor Jan Pål Loennechen, St. Olavs hospital HF and Norwegian University of Science and Technology (NTNU)
- Third member and chair of the evaluation committee: Professor II Sigrun Halvorsen, University of Oslo
Chair of the Defence
Associate Professor Jan Magnus Aronsen, University of Oslo
Principal Supervisor
PhD Øystein Lunde Holla, Sykehuset Telemark
Summary
Long QT syndrome is a disorder of the heart’s electrical activity and may lead to fainting and sudden cardiac death. It can be inherited or acquired, the latter caused by undesired QT prolongation from QT-prolonging drugs, QT-prolonging electrolyte disorders and QT-prolonging medical conditions.
The aim of the thesis Prevalence of congenital long QT syndrome and acquired QT prolongation in a hospital cohort was to investigate any clinical significance of an ECG with QTc ≥500 ms in patients admitted to a community hospital.
We reviewed the medical records of 1531 patients with QTc ≥500 ms admitted to Telemark hospital trust between January 2004 and December 2014.
Heart failure, aborted cardiac arrest, stroke/subarachnoid hemorrhage/head trauma, electrolyte disturbances, age, medication with known risk for TdP and medication with possible risk for TdP were identified as predictors of mortality in patients with QTc ≥500 ms. Based on these findings, a QTc mortality score was constructed, which demonstrated increased mortality with increasing QTc mortality score.
In addition, we found that QTc ≥500 ms was a powerful predictor of short-term mortality independent of comorbidity in hospitalized patients. For long-term mortality, comorbidity seemed to be more important than QTc prolongation.
Only a minority of identified cases were acknowledged by the patient’s physician, indicating that the general awareness of these high-risk individuals is low.
A genetic diagnosis of LQTS was obtained in 31 (6.5%) of 475 patients with QTc ≥500 ms. This is a 130-fold increase relative to the estimated population prevalence of 1:2000.
In summary, hospitalized patients with QTc ≥500 ms should be considered as high-risk patients. The QTc mortality score may be used as a tool for risk stratification in these patients. An evaluation of congenital long QT syndrome should be considered. Increased awareness of this condition among clinicians is necessary.
Additional information
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