Abstract
BackgroundAutomatic measurement becomes a preference, and indeed a necessity, when analyzing 1000 s of ECGs in the setting of either drug-inducing QT prolongation screening or genome-wide association studies of QT interval. The problem is that individual manufacturers apply different computerized algorithms to measure QT interval. We conducted a comparative study to assess the outcomes with different automated measurements of QT interval between ECG machine manufacturers and validated the related heart rate correction methods.Methods and ResultsHerein, we directly compared these different commercial systems using 10,529 Fukuda Denshi ECGs and 72,754 Nihon Kohden ECGs taken in healthy Japanese volunteers. Log-transformed data revealed an equal optimal heart rate correction formula of QT interval for Fukuda Denshi and Nihon Kohden, in the form of QTc = QT/RR−0.347. However, with the raw data, the optimal heart rate correction formula of QT interval was in the form of QTc = QT+0.156×(1-RR) for Fukuda Denshi and QTc = QT+0.152×(1-RR) for Nihon Kohden. After optimization of heart rate correction of QT interval by the linear regression model using either log-transformed data or raw data, QTc interval was ∼10 ms longer in Nihon Kohden ECGs than in those recorded on Fukuda Denshi machines. Indeed, regression analysis revealed that differences in the ECG machine used had up to a two-fold larger impact on QT variation than gender difference. Such an impact is likely to be of considerable importance when ECGs for a given individual are recorded on different machines in the setting of multi-institutional joint research.ConclusionsWe recommend that ECG machines of the same manufacturer should be used to measure QT and RR intervals in the setting of multi-institutional joint research. It is desirable to unify the computer algorithm for automatic QT and RR measurements from an ECG.
Highlights
Prolongation of the QT interval is an intermediate phenotype associated with an individual’s increased propensity to develop a ventricular tachyarrhythmia called Torsades de Pointes and increased risk of sudden cardiac death (SCD) [1,2,3,4].All new drugs must undergo a ’thorough QT/QTc’ (TQT) study to detect drug-induced QT prolongation
We evaluated resting ECGs recorded on a Fukuda Denshi machine from 10,529 adult ($20 years old) healthy subjects (8,631 males aged 46.169.2 years and 1,898 females aged 45.367.9 years) and resting ECGs recorded on a Nihon Kohden machine from 72,754 adult ($20 years old) healthy subjects (42,673 males aged 49.9615.3 years and 30,081 females aged 53.6616.5 years)
1,889 female adult resting Fukuda Denshi ECGs and the remaining 42,398 male and 29,936 female adult resting Nihon Kohden ECGs were subjected to QT interval analysis
Summary
Prolongation of the QT interval is an intermediate phenotype associated with an individual’s increased propensity to develop a ventricular tachyarrhythmia called Torsades de Pointes and increased risk of sudden cardiac death (SCD) [1,2,3,4].All new drugs must undergo a ’thorough QT/QTc’ (TQT) study to detect drug-induced QT prolongation. Prolongation of the QT interval is an intermediate phenotype associated with an individual’s increased propensity to develop a ventricular tachyarrhythmia called Torsades de Pointes and increased risk of sudden cardiac death (SCD) [1,2,3,4]. Accurate and consistent measurement of the QT/QTc interval is increasingly important for clinical benefit, and from the pharmaceutical drug safety screening perspective. Automatic measurement becomes a preference, and a necessity, when analyzing 1000 s of ECGs in the setting of either drug-inducing QT prolongation screening or genome-wide association studies of QT interval. We conducted a comparative study to assess the outcomes with different automated measurements of QT interval between ECG machine manufacturers and validated the related heart rate correction methods
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