A fundamental relationship between intraventricular conduction and heart rate

Mason, Jay W.; Badilini, Fabio; Vaglio, Martino; Lux, Robert L.; Aysin, Benhur; Moon, Thomas E.; Heinz, Brock; Strachan, Iain

doi:10.1016/j.jelectrocard.2016.03.008

Cited by 22 publications

(15 citation statements)

References 43 publications

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“…In a previous issue of the journal, Mason et al have reported data suggesting a positive relationship between QRS duration and RR interval (i.e. QRS duration decreases when RR interval decreases) (1). This result is in line with the seminal Bazett's article entitled "An analysis of the time-relations of electrocardiograms" (2) and most of the studies that have addressed the QRS/RR relationship (see below).…”

Section: Introductionsupporting

confidence: 52%

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QRS interval: What is it? How to measure it?

Extramiana

Maison‐Blanche

2016

Journal of Electrocardiology

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Section: Introductionsupporting

confidence: 52%

“…Article such as the paper by Mason et al (1) should be encouraged as they will trigger warranted experimental studies on the physiology/pathophysiology of propagation of depolarization and on quantitative ECG. These data are needed to help "electrocardiographists" in their responsibility to define the best (i.e.…”

Section: Previous Studiesmentioning

confidence: 99%

QRS interval: What is it? How to measure it?

Extramiana

Maison‐Blanche

2016

Journal of Electrocardiology

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“…Heart rate corrected intervals were obtained using a linear correction . The linear regression model for heart rate‐dependence was:

I = b + a * RR + ε

where I is an interval measurement in milliseconds, b is the intercept, a is the scaling constant (i.e.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…The participants were mainly very young adults who had no known cardiovascular complications and took no medication except for insulin. Therefore, QRS shortening may well be a feature of elevated heart rate and not of Type 1 diabetes, since the QRS duration physiologically shortens with increasing heart rate [18]. However, in a study of children and adolescents with Type 1 diabetes (n=40), the QRS duration increased compared to controls (n=20) [29].…”

Section: Depolarizationmentioning

confidence: 96%

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Cardiac repolarization and depolarization in people with Type 1 diabetes with normal ejection fraction and without known heart disease: a case‐control study

et al. 2018

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Pharmacometric and Electrocardiographic Evaluation of Chloroquine and Azithromycin in Healthy Volunteers

Chotsiri

Tärning

Hoglund

et al. 2022

Clin Pharma and Therapeutics

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Chloroquine and azithromycin were developed in combination for the preventive treatment of malaria in pregnancy, and more recently were proposed as coronavirus disease 2019 (COVID-19) treatment options. Billions of doses of chloroquine have been administered worldwide over the past 70 years but concerns regarding cardiotoxicity, notably the risk of torsades de pointes (TdP), remain. This investigation aimed to characterize the pharmacokinetics and electrocardiographic effects of chloroquine and azithromycin observed in a large previously conducted healthy volunteer study. Healthy adult volunteers (n = 119) were randomized into 5 arms: placebo, chloroquine alone (600 mg base), or chloroquine with either 500 mg, 1,000 mg, or 1,500 mg of azithromycin all given daily for 3 days. Chloroquine and azithromycin levels, measured using liquid-chromatography tandem mass spectrometry, and electrocardiograph intervals were recorded at frequent intervals. Time-matched changes in the PR, QRS, and heart rate-corrected JT, and QT intervals were calculated and the relationship with plasma concentrations was evaluated using linear and nonlinear mixed-effects modeling. Chloroquine and azithromycin pharmacokinetics were described satisfactorily by two-and three-compartment distribution models, respectively. No drug-drug interaction between chloroquine and azithromycin was observed. Chloroquine resulted in concentration-dependent prolongation of the PR, QRS, JTc and QTc intervals with a minimal additional effect of azithromycin. QRS widening contributed ~ 28% of the observed QT prolongation. Chloroquine causes significant concentration-dependent delays in both ventricular depolarization and repolarization. Co-administration of azithromycin did not significantly increase these effects. The arrhythmogenic risk of TdP associated with chloroquine may have been substantially overestimated in studies which did not separate electrocardiograph QRS and JT prolongation.

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A fundamental relationship between intraventricular conduction and heart rate

Cited by 22 publications

References 43 publications

QRS interval: What is it? How to measure it?

QRS interval: What is it? How to measure it?

Cardiac repolarization and depolarization in people with Type 1 diabetes with normal ejection fraction and without known heart disease: a case‐control study

Pharmacometric and Electrocardiographic Evaluation of Chloroquine and Azithromycin in Healthy Volunteers

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