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@article{1863139,
author = {Toman, Ondřej and Hnatkova, Katerina and Šišáková, Martina and Smetana, Peter and Huster, Katharina M. and Barthel, Petra and Novotný, Tomáš and Andršová, Irena and Schmidt, Georg and Malík, Marek},
article_location = {Lausanne},
article_number = {April 2022},
doi = {http://dx.doi.org/10.3389/fphys.2022.863873},
keywords = {healthy volunteers; long-term ECG; short-term ECG measurements; QT variability; RR variability; ECG noise contents; immediate RR interval effect; regression-based correction},
language = {eng},
issn = {1664-042X},
journal = {Frontiers in Physiology},
title = {Short-Term Beat-to-Beat QT Variability Appears Influenced More Strongly by Recording Quality Than by Beat-to-Beat RR Variability},
url = {https://www.frontiersin.org/articles/10.3389/fphys.2022.863873/full},
volume = {13},
year = {2022}
}
TY - JOUR
ID - 1863139
AU - Toman, Ondřej - Hnatkova, Katerina - Šišáková, Martina - Smetana, Peter - Huster, Katharina M. - Barthel, Petra - Novotný, Tomáš - Andršová, Irena - Schmidt, Georg - Malík, Marek
PY - 2022
TI - Short-Term Beat-to-Beat QT Variability Appears Influenced More Strongly by Recording Quality Than by Beat-to-Beat RR Variability
JF - Frontiers in Physiology
VL - 13
IS - April 2022
SP - 1-24
EP - 1-24
PB - FRONTIERS MEDIA SA
SN - 1664042X
KW - healthy volunteers
KW - long-term ECG
KW - short-term ECG measurements
KW - QT variability
KW - RR variability
KW - ECG noise contents
KW - immediate RR interval effect
KW - regression-based correction
UR - https://www.frontiersin.org/articles/10.3389/fphys.2022.863873/full
N2 - Increases in beat-to-beat variability of electrocardiographic QT interval duration have repeatedly been associated with increased risk of cardiovascular events and complications. The measurements of QT variability are frequently normalized for the underlying RR interval variability. Such normalization supports the concept of the so-called immediate RR effect which relates each QT interval to the preceding RR interval. The validity of this concept was investigated in the present study together with the analysis of the influence of electrocardiographic morphological stability on QT variability measurements. The analyses involved QT and RR measurements in 6,114,562 individual beats of 642,708 separate 10-s ECG samples recorded in 523 healthy volunteers (259 females). Only beats with high morphology correlation (r > 0.99) with representative waveforms of the 10-s ECG samples were analyzed, assuring that only good quality recordings were included. In addition to these high correlations, SDs of the ECG signal difference between representative waveforms and individual beats expressed morphological instability and ECG noise. In the intra-subject analyses of both individual beats and of 10-s averages, QT interval variability was substantially more strongly related to the ECG noise than to the underlying RR variability. In approximately one-third of the analyzed ECG beats, the prolongation or shortening of the preceding RR interval was followed by the opposite change of the QT interval. In linear regression analyses, underlying RR variability within each 10-s ECG sample explained only 5.7 and 11.1% of QT interval variability in females and males, respectively. On the contrary, the underlying ECG noise contents of the 10-s samples explained 56.5 and 60.1% of the QT interval variability in females and males, respectively. The study concludes that the concept of stable and uniform immediate RR interval effect on the duration of subsequent QT interval duration is highly questionable. Even if only stable beat-to-beat measurements of QT interval are used, the QT interval variability is still substantially influenced by morphological variability and noise pollution of the source ECG recordings. Even when good quality recordings are used, noise contents of the electrocardiograms should be objectively examined in future studies of QT interval variability.
ER -
TOMAN, Ondřej, Katerina HNATKOVA, Martina ŠIŠÁKOVÁ, Peter SMETANA, Katharina M. HUSTER, Petra BARTHEL, Tomáš NOVOTNÝ, Irena ANDRŠOVÁ, Georg SCHMIDT and Marek MALÍK. Short-Term Beat-to-Beat QT Variability Appears Influenced More Strongly by Recording Quality Than by Beat-to-Beat RR Variability. \textit{Frontiers in Physiology}. Lausanne: FRONTIERS MEDIA SA, 2022, vol.~13, April 2022, p.~1-24. ISSN~1664-042X. Available from: https://dx.doi.org/10.3389/fphys.2022.863873.
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