Fridericia's formula was the most reliable for QTc calculation in young male athletes, showing no significant correlation with heart rate and an upper normal limit of 451 msec.
Cross-Sectional (n=701)
Which QTc correction formula is the most reliable and independent of heart rate in healthy elite male athletes?
Fridericia's formula is the most reliable for QTc correction in young male athletes as it is independent of heart rate, potentially reducing overtesting compared to Bazett's formula.
A QTc interval at the upper limits in young athletes can be challenging. Regardless of factors able to influence it (age, electrolytes, etc.), several authors underlined that rate correction formulas can often underestimate/overestimate it. Our objective was to identify the most reliable formula and relative upper normal limit of QTc for this population. The rest ECG of 701 healthy elite male athletes was analyzed. QTc was calculated with 4 formulas (Bazett, Fridericia, Framingham, Hodges). Correlation/regression analysis of QTc vs. heart rate and upper limits were calculated and compared considering different age groups. Abnormal ECGs were compared considering different upper limits. Correlation between QTc and heart rate was highly significant using Bazett's and Framingham's formulas, lower using Hodges' formula, and not significant using Fridericia's formula. Except for Framingham's, the number of abnormal ECGs was identical considering an upper limit of 480 msec, and significantly different for lower limits. Upper limits were: Bazett 469 msec, Fridericia 451 msec, Framingham 458 msec, and Hodges 461 msec. Except for Framingham's, no difference among other formulas in individuating abnormal ECGs for QTc≥480 msec was found. QTc obtained with the Bazett's formula appears highly dependent on heart rate. This, especially in the grey zone (440-480 msec), can lead to overtesting. Framingham's formula shows similar limits. Hodges' formula offers uncertain reliability. Fridericia's formula seems the most reliable.
Gervasi et al. (Thu,) conducted a cross-sectional in Healthy elite male athletes (n=701). QTc correction formulas (Bazett, Fridericia, Framingham, Hodges) was evaluated on Correlation between QTc and heart rate and identification of upper normal limits. Fridericia's formula was the most reliable for QTc calculation in young male athletes, showing no significant correlation with heart rate and an upper normal limit of 451 msec.
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