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December 18, 2009Pacing and Clinical Electrophysiology

Heart Rate-Dependence of QTc Intervals Assessed by Different Correction Methods in Patients with Normal or Prolonged Repolarization

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Key result

Atrial pacing at different heart rates showed that Bazett's formula had the highest QTc variability (F=175.9), while Hodges and Karjalainen-Nomogram showed the least dependence (P<0.05).

Why the study?

Which QTc correction formula provides the least heart rate dependence in patients with normal or prolonged repolarization undergoing atrial pacing?

Population

123 dual-chamber device recipients with baseline normal or prolonged QT interval, preserved intrinsic…

Comparison

Atrial pacing at 60, 80, and 100 beats per… vs Baseline heart rate and comparison among the…

Design

Cohort

Authors

JCJohn ChiladakisGeneral University Hospital of PatrasAKAndreas P. KalogeropoulosHeart Failure & TransplantPAPanagiotis ArvanitisUppsala University

Discussion

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Member takes

Overview

QTc formulas vary in heart rate dependence among device patients; leaves open optimal method for clinical use.

Structured PICO

Which QTc correction formula provides the least heart rate dependence in patients with normal or prolonged repolarization undergoing atrial pacing?

P
Population
123 dual-chamber device recipients (mean age 68 years) with baseline normal or prolonged QT interval and preserved intrinsic ventricular activation with narrow QRS complexes.
I
Intervention
Atrial pacing at 60, 80, and 100 beats per minute with QTc interval assessment using five different correction formulae (Bazett, Fridericia, Sagie-Framingham, Hodges, and Karjalainen-Nomogram).
C
Comparator
Baseline heart rate (52 +/- 3 beats per minute) and comparison among the different QTc correction formulae.
O
Outcome
Heart rate dependence (variability) of QTc intervals derived from the five different correction methods across pacing stages.surrogate

Main Result

p-value: p=<0.05

The Hodges and Karjalainen-Nomogram formulae provide the least heart rate-dependent QTc correction, whereas the widely used Bazett's formula is the most heart rate-dependent.

Cite This Study

Chiladakis et al. (2009) studied Normal or prolonged repolarization (n=123). Atrial pacing at 60, 80, and 100 beats per minute vs. Baseline (52 +/- 3 beats per minute) was evaluated on QTc variability across heart rate stages (p=<0.05). Atrial pacing at different heart rates showed that Bazett's formula had the highest QTc variability (F=175.9), while Hodges and Karjalainen-Nomogram showed the least dependence (P<0.05).

synapsesocial.com/papers/6a6d02a331a3df824326e0fdhttps://doi.org/10.1111/j.1540-8159.2009.02657.x
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Linearly Scaled, Rate‐Invariant Normal Limits for QT Interval: Eight Decades of Incorrect Application of Power Functions2002 · 117 citations
  2. 2Hysteresis of the ventricular paced QT interval in response to abrupt changes in pacing rate1988 · 199 citations
  3. 3Relation between QT and RR intervals is highly individual among healthy subjects: implications for heart rate correction of the QT interval2002 · 442 citations