Abstract: | Background: QT interval dispersion has been proposed as a simple noninvasive predictor of ventricular arrhythmias and sudden death. Patients with thalassemia major are at increased risk for sudden death. However, the independent effect of increased QT dispersion on the risk of sudden death in thalassemia major is not known. This study sought to test the hypothesis that an abnormal QT dispersion predicts sudden death in patients with thalassemia major. Methods: QT dispersion was measured in 13 consecutive patients with thalassemia major who had sudden death at a mean age of 16.1 ± 2.8 years, and in 13 survivors matched for age, gender, examination year, and transfusion therapy. Results: Patients who died suddenly had significantly greater QT dispersion (59 ± 29 ms) than patients who survived (29 ± 13 ms; P = 0.002). A cut-off value of 50 ms for QT dispersion had a sensitivity of 54%, a specificity of 92%, a positive predictive value of 87%, a negative predictive value of 67% and a predictive accuracy of 73% in identifying patients at risk of sudden death. With multiple regression analysis, QT dispersion was the only independent predictor of sudden death. Conclusions: QT dispersion is a useful marker of risk of sudden death in patients with thalassemia major. A.N.E. 1999;4(3):295–300 |