QT correction

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cardiacnerd

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Hey All,

While many articles and studies tout the importance of correcting the QT interval for either R-R or rate, there seems to be little consensus on what this means. In fact, many educational materials discuss this concept, then provide (potentially) outdated methods that may not have great evidence behind them supporting their use versus other methods. Additionally, many resources do not address evidence, or pros and cons of different methods. I've done a bit of research, and am having little success finding any sort of professional consensus on what formula to use in different situations.

I'd like to solicit opinions and information on the subject. Key questions include:

1) Are there any professional organization recommendations on QTc correction formulas?

2) Do you have a personal opinion on the subject? If so, what is your opinion, and why?

3) Is there a standard where you work or study? If so, what is the standard? What information or evidence has been given to you supporting the standard? How do you feel about the standard?

4) Any great articles/studies on the subject? I have an entire folder of studies and articles on the subject numbering in the hundreds, but don't have a single article or study that addresses professional consensus or provides a good overview of the pros and cons of many methods, or provides a recommendation of one method over many others (some address one versus a couple others). Anything that you've read that makes you say, "Yeah, this'll work, and I feel good about using this method based on their evidence?"

I've attached an example of what happens when you correct for different heart rates using common methods based on an arbitrary measured QT of 0.41 seconds.

Thanks so much for your time, experience, and brain.

-Nerd

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  • QT 41 example.png
    QT 41 example.png
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Not sure if you've come across it, but the AHA/ACCF/HRS has a series of guideline statements on ECG standards, here's the one dealing with ST segments, T and U waves and QT interval. There's a little paragraph quickly dealing with corrected QT calculation but I'd say look at the handful of references they have in that section.

http://www.onlinejacc.org/content/accj/53/11/982.full.pdf
 
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