Key result
Underlying heart rate strongly influences QT variability indices, with QTVi showing poor intra-subject reproducibility.
Why the study?
Physiologic correlates of QT variability expressions have been little researched, especially when measured in short 10-second ECGs.
Does underlying heart rate and RR variability influence the measurement of short-term QT variability indices in healthy subjects?
Observational (n=523)
Yes
Does underlying heart rate and RR variability influence the measurement of short-term QT variability indices in healthy subjects?
p-value: p=<0.00001
Simpler expressions of QT interval variability like SDQT are more reproducible and preferable over the widely used QTVi, which is heavily confounded by heart rate and RR interval variability.
Heart rate confounds QTVi more than SDQT; leaves open whether adjusted indices or SDQT improve risk stratification in patients.
QT interval variability, mostly expressed by QT variability index (QTVi), has repeatedly been used in risk diagnostics. Physiologic correlates of QT variability expressions have been little researched especially when measured in short 10-second electrocardiograms (ECGs). This study investigated different QT variability indices, including QTVi and the standard deviation of QT interval durations (SDQT) in 657,287 10-second ECGs recorded in 523 healthy subjects (259 females). The indices were related to the underlying heart rate and to the 10-second standard deviation of RR intervals (SDRR). The analyses showed that both QTVi and SDQT (as well as other QT variability indices) were highly statistically significantly (p < 0.00001) influenced by heart rate and that QTVi showed poor intra-subject reproducibility (coefficient of variance approaching 200%). Furthermore, sequential analysis of regression variance showed that SDQT was more strongly related to the underlying heart rate than to SDRR, and that QTVi was influenced by the underlying heart rate and SDRR more strongly than by SDQT (p < 0.00001 for these comparisons of regression dependency). The study concludes that instead of QTVi, simpler expressions of QT interval variability, such as SDQT, appear preferable for future applications especially if multivariable combination with the underlying heart rate is used.
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Andršová et al. (2020) conducted an observational in Healthy subjects (n=523). Underlying heart rate and RR interval variability was evaluated on Influence of underlying heart rate on QT variability indices (QTVi and SDQT) (p=<0.00001). Underlying heart rate significantly influenced both QTVi and SDQT (p < 0.00001), with QTVi demonstrating poor intra-subject reproducibility and stronger dependence on RR variability.
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