Key result
Bazett's formula outperforms other QT corrections, predicting ~331% higher cardiac mortality risk in non-hospitalized patients.
Why the study?
QT prolongation predisposes individuals to ventricular arrhythmias and sudden cardiac death, but the optimal heart rate-corrected QT interval formula based on cardiovascular mortality in non-hospitalized Iranian populations was not established.
Which QT correction formula best predicts cardiac mortality in a non-hospitalized adult population?
Cohort (n=7,071)
Which QT correction formula best predicts cardiac mortality in a non-hospitalized adult population?
While Fridericia's formula is mathematically superior for QT correction, Bazett's formula is the strongest predictor of cardiac mortality in a general non-hospitalized population.
Answers are grounded in this paper and cite their sources.
Bazett's formula may aid outpatient cardiac mortality risk stratification; leaves open superiority over Fridericia's pending prospective validation.
BACKGROUND: QT interval as an indicator of ventricular repolarization is a clinically important parameter on an electrocardiogram (ECG). QT prolongation predisposes individuals to different ventricular arrhythmias and sudden cardiac death. The current study aimed to identify the best heart rate corrected QT interval for a non-hospitalized Iranian population based on cardiovascular mortality. METHODS: Using Fasa PERSIAN cohort study data, this study enrolled 7071 subjects aged 35-70 years. Corrected QT intervals (QTc) were calculated by the QT interval measured by Cardiax® software from ECGs and 6 different correction formulas (Bazett, Fridericia, Dmitrienko, Framingham, Hodges, and Rautaharju). Mortality status was checked using an annual telephone-based follow-up and a minimum 3-year follow-up for each participant. Bland-Altman, QTc/RR regression, sensitivity analysis, and Cox regression were performed in IBM SPSS Statistics v23 to find the best QT. Also, for calculating the upper and lower limits of normal of different QT correction formulas, 3952 healthy subjects were selected. RESULTS: In this study, 56.4% of participants were female, and the mean age was 48.60 ± 9.35 years. Age, heart rate in females, and QT interval in males were significantly higher. The smallest slopes of QTc/RR analysis were related to Fridericia in males and Rautaharju followed by Fridericia in females. Thus, Fridericia's formula was identified as the best mathematical formula and Bazett's as the worst in males. In the sensitivity analysis, however, Bazett's formula had the highest sensitivity (23.07%) among all others in cardiac mortality. Also, in the Cox regression analysis, Bazett's formula was better than Fridericia's and was identified as the best significant cardiac mortality predictor (Hazard ratio: 4.31, 95% CI 1.73-10.74, p value = 0.002). CONCLUSION: Fridericia was the best correction formula based on mathematical methods. Bazett's formula despite its poorest performance in mathematical methods, was the best one for cardiac mortality prediction. Practically, it is suggested that physicians use QTcB for a better evaluation of cardiac mortality risk. However, in population-based studies, QTcFri might be the one to be used by researchers.
No takes yet. Share an insight, caveat, or question.
Yazdanpanah et al. (2022) conducted a cohort in Non-hospitalized population (n=7,071). Bazett's QT correction formula vs. Other QT correction formulas (Fridericia, Dmitrienko, Framingham, Hodges, Rautaharju) was evaluated on Cardiac mortality (HR 4.31, 95% CI 1.73-10.74, p=0.002). Bazett's formula was identified as the best significant cardiac mortality predictor compared to other QT correction formulas in a non-hospitalized population.
Synapse has enriched 10 related papers. Consider them for comparative context: