Prolonged QTc interval is an independent predictor of poor outcome in aSAH and increases the risk of sudden cardiac death. However, little is known about factors associated with prolonged QTc interval after aSAH. We aimed to investigate predictors of prolonged QTc interval using aneurysm locations and 4^th ventricular hemorrhage.

Our cohort had 84 patients [66% female, mean age 53.9 (±13) years]. Overall, 41.6% (35) patients had posterior circulation aneurysms and 38% (32) had 4^th ventricular hemorrhage. Overall incidence of prolonged QTc interval was 44% and sudden cardiac death was 4.7%. 9.5% of patients developed sinus bradycardia (HR <50) within 48 hours. 45.7% (16) of posterior circulation aSAH and 65.6% (21) with 4^th ventricular hemorrhage had prolonged QTc interval. In multivariate analysis, 4^th ventricular hemorrhage was associated with 4.5 fold higher odds of QTc prolongation [OR:4.52 (95% CI 1.6-12.7; p=0.004)]. Aneurysm location was not a statistically significant predictor.

Incidence of prolonged QTc interval was similar in anterior and posterior circulation aSAH. Presence of 4^th ventricular hemorrhage, and not the location of aneurysm, age or gender, was a strong predictor of prolonged QTc interval in our patients with aSAH. Studies with larger cohorts are required to confirm our findings.