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

J 2020

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

ANDRŠOVÁ, Irena, Katerina HNATKOVA, Kateřina HELÁNOVÁ, Martina ŠIŠÁKOVÁ, Tomáš NOVOTNÝ et. al.

Základní údaje

Originální název

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

Autoři

ANDRŠOVÁ, Irena (203 Česká republika, domácí), Katerina HNATKOVA (203 Česká republika), Kateřina HELÁNOVÁ (203 Česká republika, domácí), Martina ŠIŠÁKOVÁ (203 Česká republika, domácí), Tomáš NOVOTNÝ (203 Česká republika, domácí), Petr KALA (203 Česká republika, domácí) a Marek MALÍK (203 Česká republika, garant)

Vydání

BMC Pediatrics, LONDON, BMC, 2020, 1471-2431

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30209 Paediatrics

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.125

Kód RIV

RIV/00216224:14110/20:00117690

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1186/s12887-020-02460-8

UT WoS

000599854700002

Klíčová slova anglicky

Long QT screening; QTc prolongation in children; Bazett correction; Fridericia correction; Framingham correction

Štítky

14110211, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 12. 1. 2021 08:57, Mgr. Tereza Miškechová

Anotace

V originále

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 <440ms, 440-460ms, 460-480ms, and>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>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 (<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.

Citovat

ANDRŠOVÁ, Irena, Katerina HNATKOVA, Kateřina HELÁNOVÁ, Martina ŠIŠÁKOVÁ, Tomáš NOVOTNÝ, Petr KALA a Marek MALÍK. Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval. BMC Pediatrics. LONDON: BMC, 2020, roč. 20, č. 1, s. 1-10. ISSN 1471-2431. Dostupné z: https://dx.doi.org/10.1186/s12887-020-02460-8.

@article{1725797,
   author = {Andršová, Irena and Hnatkova, Katerina and Helánová, Kateřina and Šišáková, Martina and Novotný, Tomáš and Kala, Petr and Malík, Marek},
   article_location = {LONDON},
   article_number = {1},
   doi = {http://dx.doi.org/10.1186/s12887-020-02460-8},
   keywords = {Long QT screening; QTc prolongation in children; Bazett correction; Fridericia correction; Framingham correction},
   language = {eng},
   issn = {1471-2431},
   journal = {BMC Pediatrics},
   title = {Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval},
   url = {https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-020-02460-8.pdf},
   volume = {20},
   year = {2020}
}

TY  - JOUR
ID  - 1725797
AU  - Andršová, Irena - Hnatkova, Katerina - Helánová, Kateřina - Šišáková, Martina - Novotný, Tomáš - Kala, Petr - Malík, Marek
PY  - 2020
TI  - Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval
JF  - BMC Pediatrics
VL  - 20
IS  - 1
SP  - 1-10
EP  - 1-10
PB  - BMC
SN  - 14712431
KW  - Long QT screening
KW  - QTc prolongation in children
KW  - Bazett correction
KW  - Fridericia correction
KW  - Framingham correction
UR  - https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-020-02460-8.pdf
L2  - https://bmcpediatr.biomedcentral.com/track/pdf/10.1186/s12887-020-02460-8.pdf
N2  - 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 <440ms, 440-460ms, 460-480ms, and>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>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 (<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.
ER  -

ANDRŠOVÁ, Irena, Katerina HNATKOVA, Kateřina HELÁNOVÁ, Martina ŠIŠÁKOVÁ, Tomáš NOVOTNÝ, Petr KALA a Marek MALÍK. Problems with Bazett QTc correction in paediatric screening of prolonged QTc interval. \textit{BMC Pediatrics}. LONDON: BMC, 2020, roč.~20, č.~1, s.~1-10. ISSN~1471-2431. Dostupné z: https://dx.doi.org/10.1186/s12887-020-02460-8.

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