Application of the Bogossian formula for evaluation of the QT interval in pacemaker patients with stimulated left bundle branch block

Weipert, Kay; Bogossian, Harilaos; Conzen, P.; Frommeyer, Gerrit; Gemein, Christopher; Helmig, Inga; Chasan, Ritvan; Eckardt, Lars; Seyfarth, Melchior; Lemke, Bernd; Zarse, Markus; Hamm, C; Schmitt, J; Erkapic, Damir

doi:10.1007/s00392-018-1275-6

Cited by 8 publications

(12 citation statements)

References 18 publications

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“…*applicability of this formula in RBBB was shown in a following publication [26] . **further assessment performed in four following publications [22] , [23] , [25] , [26] . ***further assessment performed in the same publication [20] .…”

Section: Assessing Qt-interval In the Presence Of Bundle-branch Blockmentioning

confidence: 99%

“…Another patient population with intermittent artificial LBBB are patients with implanted pacemakers. A further step in the analysis of the formula was therefore to check the applicability of the formula in these patients [23] . In total, 163 patients with a cardiac one- or two-chamber pacemaker were included in this prospective, multicentre observational study.…”

Section: Assessing Qt-interval In the Presence Of Bundle-branch Blockmentioning

confidence: 99%

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QTc evaluation in patients with bundle branch block

Bogossian

Linz

Heijman

et al. 2020

IJC Heart & Vasculature

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Proper measurement of the QT interval on the 12-lead body-surface ECG is challenging in daily practice. Even more difficult is its correct estimation in the presence of repolarization abnormalities, arrhythmias or bundle-branch blocks (BBB). The QT interval results from two parts of the ECG: (1) the QRS complex, describing the excitation of the ventricles and (2) the JT interval, describing the repolarisation of the ventricles. Prolongation of the QRS width – like in the presence of BBB – entails prolongation of the QT interval, making the estimation of the true repolarisation time challenging. The US recommendations for the standardization and interpretation of the ECG suggest focusing on the JT interval in presence of BBB. However, in clinical practice physicians have become more familiar with the interpretation of QT-interval measurements than with the interpretation of the JT Interval. In the last decade, a simple formula for the estimation of the “modified QT interval” in the presence of left or right BBB has been developed and evaluated. In this formula, the modified QT interval is calculated by subtracting 50% of the length of the BBB-QRS from the measured QT interval (QT m = QT BBB − 50% QRS BBB ). Subsequently, rate-correction formula should be applied as usual. In this review, we discuss the determination of the QT-interval in the presence of BBB and summarize the origin and application of the modified QT-interval formula.

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Section: Assessing Qt-interval In the Presence Of Bundle-branch Blockmentioning

confidence: 99%

Section: Assessing Qt-interval In the Presence Of Bundle-branch Blockmentioning

confidence: 99%

QTc evaluation in patients with bundle branch block

Bogossian

Linz

Heijman

et al. 2020

IJC Heart & Vasculature

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“…4 It is known that a higher heart rate results in an increasing difference between intrinsic and heart rate corrected QT interval. 6,7,19 While the Bazett formula leaves a strong positive residual correlation with heart rate, the Fridericia formula leaves a negative correlation. 3 For heart rate-dependent QT correction using Bazett's or Fridericia's formulas deviations of more than 20 ms are considered to be possible.…”

Section: Discussionmentioning

confidence: 99%

“…The observed overestimation with the Bazett formula of up to 20 ms, in the current study, is in line with our previous results of LBBB correction using the combination of the Bogossian and the Bazett formulas. 6,7 To avoid a potential false positive QT prolongation using the Bazett formula or possible false negative QT prolongation using the Fridericia formula, the Hodge formula seems to be the best one for the combination with the Bogossian formula in assessing the "true" QTc interval in RBBB with additional block of one of the left ventricular fascicles.…”

Section: Discussionmentioning

confidence: 99%

“…4 Application of this so-called "Bogossian formula," in combination with the Bazett formula for heart rate correction showed to be a simple and reliable tool in clinical practice for QTc interval evaluation in patients with preserved or reduced left ventricular ejection fraction and LBBB. [4][5][6][7] However, the importance of the Bogossian formula has never been evaluated in patients with RBBB or bifascicular block. Moreover, for QTc interval evaluation, the Bogossian formula has never been combined with Fridericia's or Hodge's formulas.…”

Section: Introductionmentioning

confidence: 99%

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QTc interval evaluation in patients with right bundle branch block or bifascicular blocks

Erkapic

Frommeyer

Brettner

et al. 2020

Clinical Cardiology

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Background The right bundle branch block (RBBB) and the bifascicular blocks affect QRS duration in the right precordial leads, which are usually used for QT interval determination. Up to now, there is no clear recommendation how to determine QT interval in patients with RBBB or bifascicular block. Hypothesis The hypothesis of the present study was to evaluate the feasibility of a simple formula for RBBB and bifascicular block correction, thereby making it easier to determine the QTc interval. Methods In patients with intrinsic QRS duration <120 ms, artificial RBBB with either left posterior (LPFB) or left anterior fascicular block (LAFB), created by left ventricular pacing maneuvers, were corrected using the Bogossian formula (QTm) and afterward were heart rate corrected (QTmc). Heart rate correction was performed using different heart rate formulas in comparison to each other. The QTmc intervals were compared in each patient with the QTc interval during intrinsic rhythm. Results A total of scheduled 71 patients were included in this prospective multicenter observational comparative study. Compared to intrinsic QTc interval, the mean ΔQTmc interval by combination of the Bogossian and the Hodge formulas was −3 ± 24 ms in RBBB + LPFB (P = .44) and −6 ± 25 ms in RBBB + LAFB (P = .15). The Bogossian formula showed a significant deviation from the actual QTc interval with both the Bazett and the Fridericia formulas. Conclusion In combination with the Hodge formula, the Boggosian formula delivered the best results in comparing the true QTc interval in narrow QRS with the QTmc interval in the presence of a bifascicular block.

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AV conduction mode switch in a leadless pacemaker potentially contributing to ventricular fibrillation

Lee,

Mahmoodi,

Haqqani

et al. 2024

HeartRhythm Case Reports

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Application of the Bogossian formula for evaluation of the QT interval in pacemaker patients with stimulated left bundle branch block

Abstract: The Bogossian formula is a reliable tool for QTc interval evaluation in pacemaker patients with LBBB due to apical or non-apical RV pacing. However, an overestimation of 30 ms should be included in the calculation.

Cited by 8 publications

References 18 publications

QTc evaluation in patients with bundle branch block

QTc evaluation in patients with bundle branch block

QTc interval evaluation in patients with right bundle branch block or bifascicular blocks

AV conduction mode switch in a leadless pacemaker potentially contributing to ventricular fibrillation

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