Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216224%3A14110%2F20%3A00117690" target="_blank" >RIV/00216224:14110/20:00117690 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/65269705:_____/20:00073672

Výsledek na webu

<a href="https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-020-02460-8.pdf" target="_blank" >https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-020-02460-8.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1186/s12887-020-02460-8" target="_blank" >10.1186/s12887-020-02460-8</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval

Popis výsledku v původním jazyce

BackgroundBazett formula is frequently used in paediatric screening for the long QT syndrome (LQTS) and proposals exist that using standing rather than supine electrocardiograms (ECG) improves the sensitivity of LQTS diagnosis. Nevertheless, compared to adults, children have higher heart rates (especially during postural provocations) and Bazett correction is also known to lead to artificially prolonged QTc values at increased heart rates. This study assessed the incidence of erroneously increased QTc values in normal children without QT abnormalities.MethodsContinuous 12-lead ECGs were recorded in 332 healthy children (166 girls) aged 10.72.6years while they performed postural manoeuvring consisting of episodes (in the following order) of supine, sitting, standing, supine, standing, sitting, and supine positions, each lasting 10min. Detailed analyses of QT/RR profiles confirmed the absence of prolonged individually corrected QTc interval in each child. Heart rate and QT intervals were measured in 10-s ECG segments and in each segment, QTc intervals were obtained using Bazett, Fridericia, and Framingham formulas. In each child, the heart rates and QTc values obtained during supine, sitting and standing positions were averaged. QTc durations by the three formulas were classified to &lt;440ms, 440-460ms, 460-480ms, and&gt;480ms.ResultsAt supine position, averaged heart rate was 77.5 +/- 10.5 beat per minute (bpm) and Bazett, Fridericia and Framingham QTc intervals were 425.3 +/- 15.8, 407.8 +/- 13.9, and 408.2 +/- 13.1ms, respectively. At sitting and standing, averaged heart rate increased to 90.9 +/- 10.1 and 100.9 +/- 10.5bpm, respectively. While Fridericia and Framingham formulas showed only minimal QTc changes, Bazett correction led to QTc increases to 435 +/- 15.1 and 444.9 +/- 15.9ms at sitting and standing, respectively. At sitting, Bazett correction identified 51, 4, and 0 children as having the QTc intervals 440-460, 460-480, and&gt;480ms, respectively. At sitting, these numbers increased to 118, 11, and 1, while on standing these numbers were 151, 45, and 5, respectively. Irrespective of the postural position, Fridericia and Framingham formulas identified only a small number (&lt;7) of children with QT interval between 440 and 460ms and no children with longer QTc.Conclusion During screening for LQTS in children, the use of Bazett formula leads to a high number of false positive cases especially if the heart rates are increased (e.g. by postural manoeuvring). The use of Fridericia formula can be recommended to replace the Bazett correction not only for adult but also for paediatric ECGs.

Název v anglickém jazyce

Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval

Popis výsledku anglicky

BackgroundBazett formula is frequently used in paediatric screening for the long QT syndrome (LQTS) and proposals exist that using standing rather than supine electrocardiograms (ECG) improves the sensitivity of LQTS diagnosis. Nevertheless, compared to adults, children have higher heart rates (especially during postural provocations) and Bazett correction is also known to lead to artificially prolonged QTc values at increased heart rates. This study assessed the incidence of erroneously increased QTc values in normal children without QT abnormalities.MethodsContinuous 12-lead ECGs were recorded in 332 healthy children (166 girls) aged 10.72.6years while they performed postural manoeuvring consisting of episodes (in the following order) of supine, sitting, standing, supine, standing, sitting, and supine positions, each lasting 10min. Detailed analyses of QT/RR profiles confirmed the absence of prolonged individually corrected QTc interval in each child. Heart rate and QT intervals were measured in 10-s ECG segments and in each segment, QTc intervals were obtained using Bazett, Fridericia, and Framingham formulas. In each child, the heart rates and QTc values obtained during supine, sitting and standing positions were averaged. QTc durations by the three formulas were classified to &lt;440ms, 440-460ms, 460-480ms, and&gt;480ms.ResultsAt supine position, averaged heart rate was 77.5 +/- 10.5 beat per minute (bpm) and Bazett, Fridericia and Framingham QTc intervals were 425.3 +/- 15.8, 407.8 +/- 13.9, and 408.2 +/- 13.1ms, respectively. At sitting and standing, averaged heart rate increased to 90.9 +/- 10.1 and 100.9 +/- 10.5bpm, respectively. While Fridericia and Framingham formulas showed only minimal QTc changes, Bazett correction led to QTc increases to 435 +/- 15.1 and 444.9 +/- 15.9ms at sitting and standing, respectively. At sitting, Bazett correction identified 51, 4, and 0 children as having the QTc intervals 440-460, 460-480, and&gt;480ms, respectively. At sitting, these numbers increased to 118, 11, and 1, while on standing these numbers were 151, 45, and 5, respectively. Irrespective of the postural position, Fridericia and Framingham formulas identified only a small number (&lt;7) of children with QT interval between 440 and 460ms and no children with longer QTc.Conclusion During screening for LQTS in children, the use of Bazett formula leads to a high number of false positive cases especially if the heart rates are increased (e.g. by postural manoeuvring). The use of Fridericia formula can be recommended to replace the Bazett correction not only for adult but also for paediatric ECGs.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30209 - Paediatrics

Projekt

<a href="/cs/project/NV19-02-00197" target="_blank" >NV19-02-00197: Hodnocení dynamiky srdeční repolarizace při autonomních provokačních testech u dětí a vývoje mezipohlavních rozdílů u dospívajících</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

BMC Pediatrics

ISSN

1471-2431

e-ISSN

1471-2431

Svazek periodika

20

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

10

Strana od-do

1-10

Kód UT WoS článku

000599854700002

EID výsledku v databázi Scopus

2-s2.0-85098475655