The development and validation of an easy to use automatic QT-interval algorithm

Hermans, Ben J. M.; Vink, Arja S.; Bennis, Frank C.; Filippini, Luc; Meijborg, Veronique M.F.; Wilde, Arthur A.M.; Pison, Laurent; Postema, Pieter G.; Delhaas, Tammo

doi:10.1371/journal.pone.0184352

Cited by 22 publications

(20 citation statements)

References 28 publications

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“…The R-peak, QRS-onset, and T-wave end were detected using our previously described algorithms. 17 In short, the R-peak was detected on the root mean square of the ECG (ECG RMS ) using the Pan–Tompkins algorithm. 18 The onset of the QRS-complex was defined as the largest positive peak in the second derivative of the ECG RMS preceding the R-peak.…”

Section: Methodsmentioning

confidence: 99%

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Pulmonary vein isolation in a real-world population does not influence QTc interval

et al. 2021

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Aims We aimed to examine whether routine pulmonary vein isolation (PVI) induces significant ventricular repolarization changes as suggested earlier. Methods and results Five-minute electrocardiograms were recorded at hospital’s admission (T−1d), 1 day after the PVI-procedure (T+1d) and at 3 months post-procedure (T+3m) from a registry of consecutive atrial fibrillation (AF) patients scheduled for routine PVI with different PVI modalities (radiofrequency, cryo-ablation, and hybrid). Only patients who were in sinus rhythm at all three recordings (n = 117) were included. QT-intervals and QT-dispersion were evaluated with custom-made software and QTc was calculated using Bazett’s, Fridericia’s, Framingham’s, and Hodges’ formulas. Both QT- and RR-intervals were significantly shorter at T+1d (399 ± 37 and 870 ± 141 ms) and T+3m (407 ± 36 and 950 ± 140 ms) compared with baseline (417 ± 36 and 1025 ± 164 ms). There was no statistically significant within-subject difference in QTc Fridericia (T−1d 416 ± 28 ms, T+1d 419 ± 33 ms, and T+3m 414 ± 25 ms) and QT-dispersion (T−1d 18 ± 12 ms, T+1d 21 ± 19 ms, and T+3m 17 ± 12 ms) between the recordings. A multiple linear regression model with age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence to predict the change in QTc at T+3m with respect to QTc at T−1d did not reach significance which indicates that the change in QTc does not differ between all subgroups (age, sex, AF type, ablation technique, first/re-do ablation, and AF recurrence). Conclusion Based on our data a routine PVI does not result in a prolongation of QTc in a real-world population. These findings, therefore, suggest that there is no need to intensify post-PVI QT-interval monitoring.

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Section: Methodsmentioning

confidence: 99%

“…The end of the T-wave was detected by means of an automated tangent method. 17 All landmarks and median complexes were checked manually and edited or deleted when necessary. QTc was calculated using Fridericia’s, Hodges’, Framingham’s, and Bazett’s formula.…”

Section: Methodsmentioning

confidence: 99%

Pulmonary vein isolation in a real-world population does not influence QTc interval

et al. 2021

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“…To improve ECG signal-to-noise ratio, a median complex was constructed for every 2 min by aligning all complexes within these two minutes on the R-peak. QT-intervals were determined offline using an automated tangent approach by a custom-made algorithm in MATLAB (2017a, Mathworks, Natick, MA, USA) 18 . All ECG landmarks were checked manually by one observer who was blinded for the treatment.…”

Section: Methodsmentioning

confidence: 99%

Effect of citric-acid dialysate on the QTC-interval

Meulen

Hermans

Sande

et al. 2021

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Lower dialysate calcium (dCa) concentration and dialysate citric-acidification may positively affect calcification propensity in serum of haemodialysis (HD) patients. However, the accompanying lower ionized blood calcium concentration may lead to a prolonged cardiac action potential, which is possibly pro-arrhythmic. The aim of this study is to investigate the influence of citric-acid dialysate on the QT-interval corrected for heart rate (QTc) compared to conventional dialysate with different dCa concentrations. We conducted a four-week multicentre, randomized cross-over trial. In week one and three patients received acetic-acid dialysate with a dCa of 1.50 mmol/l (A1.5), in week two and four acetic-acid dialysate with a dCa of 1.25 mmol/l (A1.25) or citric-acid dialysate (1.0 mmol/l) with a dCa of 1.50 mmol/l (C1.5) depending on randomization. Patients had continuous ECG monitoring during one session in week one, two and four. The data of 13 patients were available for analysis. Results showed a significant though limited increase of QTc with C1.5 (from 427 to 444 ms (start to end); p = 0.007) and with A1.25 (from 431 to 449 ms; p < 0.001), but not with A1.5 (from 439 to 443 ms; p = 0.13). In conclusion, we found that the use of C1.5 or A1.25 is associated with a significant prolongation of QTc which was however relatively limited.

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“…RR intervals and the Q and T end points were extracted using an algorithm based on Hermans et al (2017) . In the original version of the algorithm, it was used to determine the length of intervals in a 12-lead ECG recording.…”

Section: Methodsmentioning

confidence: 99%

Information Flow Between Heart Rhythm, Repolarization, and the Diastolic Interval Series for Healthy Individuals and LQTS1 Patients

2021

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Using information theoretic measures, relations between heart rhythm, repolarization in the tissue of the heart, and the diastolic interval time series are analyzed. These processes are a fragment of the cardiovascular physiological network. A comparison is made between the results for 84 (42 women) healthy individuals and 65 (45 women) long QT syndrome type 1 (LQTS1) patients. Self-entropy, transfer entropy, and joint transfer entropy are calculated for the three time series and their combinations. The results for self-entropy indicate the well-known result that regularity of heart rhythm for healthy individuals is larger than that of QT interval series. The flow of information depends on the direction with the flow from the heart rhythm to QT dominating. In LQTS1 patients, however, our results indicate that information flow in the opposite direction may occur—a new result. The information flow from the heart rhythm to QT dominates, which verifies the asymmetry seen by Porta et al. in the variable tilt angle experiment. The amount of new information and self-entropy for LQTS1 patients is smaller than that for healthy individuals. However, information transfers from RR to QT and from DI to QT are larger in the case of LQTS1 patients.

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The development and validation of an easy to use automatic QT-interval algorithm

Cited by 22 publications

References 28 publications

Pulmonary vein isolation in a real-world population does not influence QTc interval

Pulmonary vein isolation in a real-world population does not influence QTc interval

Effect of citric-acid dialysate on the QTC-interval

Information Flow Between Heart Rhythm, Repolarization, and the Diastolic Interval Series for Healthy Individuals and LQTS1 Patients

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