QT correction across the heart rate spectrum, in atrial fibrillation and ventricular conduction defects

Vandenberk, Bert; Vandael, Eline; Robyns, Tomas; Vandenberghe, Joris; Garweg, Christophe; Foulon, Veerle; Ector, Joris; Willems, Rik

doi:10.1111/pace.13423

Cited by 13 publications

(21 citation statements)

References 21 publications

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“…Most differences between patients with a prolonged QTcB vs QTcA can be explained by an improved HR correction with QTcA . Using QTcA, significant differences in presenting acute or chronic illness associated with an increased HR were no longer present.…”

Section: Discussionmentioning

confidence: 99%

“…HR, QRS duration (QRSd), QT‐interval, and the underlying rhythm (sinus, AF, ventricular pacing, and other) were collected for further analysis. The corresponding QTcB and QTcA values were calculated using the following formulas (intervals are expressed in seconds (s) for uniform interpretation): Bazett = QT/RR 1/2 QTcA if QRSd ≤ 120 millisecond: Fridericia = QT/RR 1/3 QTcA if QRSd > 120 millisecond: Rautaharju = QT − 0.155 (RR‐1) − 0.93 (QRS − 0.139) + k (k = − 0.022 seconds for men and −0.034 seconds for women)…”

Section: Methodsmentioning

confidence: 99%

“…HR, QRS duration (QRSd), QT-interval, and the underlying rhythm (sinus, AF, ventricular pacing, and other) were collected for further analysis. The corresponding QTcB and QTcA values were calculated using the following formulas (intervals are expressed in seconds (s) for uniform interpretation) 10 : This study was approved by the ethical committee of the University Hospitals of Leuven. Given the retrospective design of the study, the need for informed consent was waived.…”

Section: Study Population and Designmentioning

confidence: 99%

“…This could lead to a large number of patients misclassified by automatic warning systems incorporating QTcB as having an increased risk and requiring more intensive medical follow‐up, whereas better correction formulas are available. We recently presented a patient‐specific QT correction algorithm (QTcA) on the basis of the superior heart rate (HR) correction of Fridericia's correction formula in patients with sinus rhythm and atrial fibrillation (AF) without VCD, and Rautaharju's correction formula in patients with ventricular pacing (VP) or VCD …”

Section: Introductionmentioning

confidence: 99%

“…We recently presented a patient-specific QT correction algorithm (QTcA) on the basis of the superior heart rate (HR) correction of Fridericia's correction formula in patients with sinus rhythm and atrial fibrillation (AF) without VCD, and Rautaharju's correction formula in patients with ventricular pacing (VP) or VCD. 10 The present study aimed to investigate the use of an adequately corrected QTc-interval as risk stratification tool for mortality, cardiovascular events, and hospital admission in patients admitted to the emergency department (ED). An age-and sex-matched retrospective case-control study, powered for the primary endpoint of in-hospital mortality comparing patients with normal and prolonged QTc-intervals, was performed at the ED of our tertiary care university hospital.…”

Section: Introductionmentioning

confidence: 99%

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A prolonged QTc‐interval at the emergency department: Should we always be prepared for the worst?

Vandenberk

Siau

Vandael

et al. 2019

Cardiovasc electrophysiol

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Introduction QTc‐interval prolongation is associated with ventricular arrhythmias and mortality in a general population. Bazett's correction formula (QTcB) is routinely used despite its overcorrection at high heart rates. Recently, we proposed a patient‐specific QT correcting algorithm (QTcA) resulting in improved rate correction and predictive value in a general population. We hypothesize risk stratification at the Emergency Department (ED) could be improved using QTcA. Methods and Results A retrospective case‐control study including a randomized age‐ and sex‐matched control population was performed at a tertiary care ED. A total of 1930 patients were included in the analysis (63.0% males, age 71.5 ± 15.6 years). Patient characteristics, history, and test results at the time of the electrocardiogram were collected. QTc was dichotomized as prolonged (>450 millisecond for men, >470 millisecond for women) or severely prolonged (>500 millisecond). Implementation of QTcA would reduce the number of patients considered to have a prolonged QTc by 65.2%, for severely prolonged QTc 79.6%. Multivariate regression was performed for in‐hospital mortality, cardiovascular endpoints, and hospital admission. Neither a prolonged QTcB (HR 1.04; 95% CI, 0.64‐1.69) nor QTcA (HR 0.76; 95% CI, 0.42‐1.38) was an independent predictor of in‐hospital mortality. A severely prolonged QTcA (OR, 2.54; 95% CI, 1.04‐6.23) was an independent predictor of cardiovascular events. Both a prolonged QTcA (OR, 1.52; 95% CI, 1.06‐2.18) and a prolonged QTcB (OR, 1.37; 95% CI, 1.05‐1.79) were associated with higher hospitalization rates. Conclusions QTcA reduced the number of patients considered at risk. Neither QTcB nor QTcA were predictors of in‐hospital mortality. A severely prolonged QTcA was associated with cardiovascular events.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Population and Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A prolonged QTc‐interval at the emergency department: Should we always be prepared for the worst?

Vandenberk

Siau

Vandael

et al. 2019

Cardiovasc electrophysiol

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Impact of Heart Rate and Rhythm on Corrected QT Interval During Paroxysmal Atrial Fibrillation

Wen

Ruan

et al. 2022

The American Journal of Cardiology

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Current knowledge on the dynamic changes of corrected QT (QTc) before, during, and after an atrial fibrillation (AF) episode is limited. It remains controversial which of the presently available formulas performs the best in calculating QTc during AF. This study was designed to explore whether an AF attack would affect QTc and to determine the performance of 6 available formulas in correcting QT before, during, and after AF. A total of 101 patients with Holter-documented paroxysmal AF were enrolled. QT interval before, during, and after AF was measured and corrected to heart rate (HR) by using Bazett, Fridericia, Framingham, Hodges, Dmitrienko, and RTHa formulas. In 40 patients, QTc under AF was compared with under sinus rhythm (SR) with identical HR. Although QT was significantly longer before AF and after AF compared with during AF; there was no difference in QTc between SR and AF with identical HR regardless of the formulas used. QTc calculated by the Framingham formula showed excellent homogeneity with a mean delta difference of À0.2 § 41.6 ms (before AF vs AF) and À6.6 § 35.4 ms (after AF vs AF), respectively. QTc corrected by the Bazett formula (before AF vs AF À38.7 § 52.3 ms; after AF vs AF À42.6 § 46.9 ms) yielded significant heterogeneity among the 3 time points. In conclusion, AF does not influence QTc. The Framingham formula accurately corrects QT without being affected by the AF episode. The Bazett formula significantly overestimated QTc during AF.

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Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients

Vandenberk

Engelen

Sijpe

et al. 2021

IJC Heart & Vasculature

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QT correction across the heart rate spectrum, in atrial fibrillation and ventricular conduction defects

Abstract: A patient-specific QT correction algorithm would combine accurate heart rate correction, improved predictive value of mortality, and a reduction of patients considered to be at risk.

Cited by 13 publications

References 21 publications

A prolonged QTc‐interval at the emergency department: Should we always be prepared for the worst?

A prolonged QTc‐interval at the emergency department: Should we always be prepared for the worst?

Impact of Heart Rate and Rhythm on Corrected QT Interval During Paroxysmal Atrial Fibrillation

Repolarization abnormalities on admission predict 1-year outcome in COVID-19 patients

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