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Recent heart rate history affects QT interval duration in atrial fibrillation

QT interval prolongation is associated with a risk of polymorphic ventricular tachycardia. QT interval shortens with increasing heart rate and correction for this effect is necessary for meaningful QT interval assessment. We aim to improve current methods of correcting the QT interval during atrial...

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Autores principales: Riad, Fady S., Razak, Eathar, Saba, Samir, Shalaby, Alaa, Nemec, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342318/
https://www.ncbi.nlm.nih.gov/pubmed/28273109
http://dx.doi.org/10.1371/journal.pone.0172962
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author Riad, Fady S.
Razak, Eathar
Saba, Samir
Shalaby, Alaa
Nemec, Jan
author_facet Riad, Fady S.
Razak, Eathar
Saba, Samir
Shalaby, Alaa
Nemec, Jan
author_sort Riad, Fady S.
collection PubMed
description QT interval prolongation is associated with a risk of polymorphic ventricular tachycardia. QT interval shortens with increasing heart rate and correction for this effect is necessary for meaningful QT interval assessment. We aim to improve current methods of correcting the QT interval during atrial fibrillation (AF). Digitized Holter recordings were analyzed from patients with AF. Models of QT interval dependence on RR intervals were tested by sorting the beats into 20 bins based on corrected RR interval and assessing ST-T variability within the bins. Signal-averaging within bins was performed to determine QT/RR dependence. Data from 30 patients (29 men, 69.3±7.3 years) were evaluated. QT behavior in AF is well described by a linear function (slope ~0.19) of steady-state corrected RR interval. Corrected RR is calculated as a combination of an exponential weight function with time-constant of 2 minutes and a smaller “immediate response” component (weight ~ 0.18). This model performs significantly (p<0.0001) better than models based on instantaneous RR interval only including Bazett and Fridericia. It also outperforms models based on shorter time-constants and other previously proposed models. This model may improve detection of repolarization delay in AF. QT response to heart rate changes in AF is similar to previously published QT dynamics during atrial pacing and in sinus rhythm.
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spelling pubmed-53423182017-03-29 Recent heart rate history affects QT interval duration in atrial fibrillation Riad, Fady S. Razak, Eathar Saba, Samir Shalaby, Alaa Nemec, Jan PLoS One Research Article QT interval prolongation is associated with a risk of polymorphic ventricular tachycardia. QT interval shortens with increasing heart rate and correction for this effect is necessary for meaningful QT interval assessment. We aim to improve current methods of correcting the QT interval during atrial fibrillation (AF). Digitized Holter recordings were analyzed from patients with AF. Models of QT interval dependence on RR intervals were tested by sorting the beats into 20 bins based on corrected RR interval and assessing ST-T variability within the bins. Signal-averaging within bins was performed to determine QT/RR dependence. Data from 30 patients (29 men, 69.3±7.3 years) were evaluated. QT behavior in AF is well described by a linear function (slope ~0.19) of steady-state corrected RR interval. Corrected RR is calculated as a combination of an exponential weight function with time-constant of 2 minutes and a smaller “immediate response” component (weight ~ 0.18). This model performs significantly (p<0.0001) better than models based on instantaneous RR interval only including Bazett and Fridericia. It also outperforms models based on shorter time-constants and other previously proposed models. This model may improve detection of repolarization delay in AF. QT response to heart rate changes in AF is similar to previously published QT dynamics during atrial pacing and in sinus rhythm. Public Library of Science 2017-03-08 /pmc/articles/PMC5342318/ /pubmed/28273109 http://dx.doi.org/10.1371/journal.pone.0172962 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Riad, Fady S.
Razak, Eathar
Saba, Samir
Shalaby, Alaa
Nemec, Jan
Recent heart rate history affects QT interval duration in atrial fibrillation
title Recent heart rate history affects QT interval duration in atrial fibrillation
title_full Recent heart rate history affects QT interval duration in atrial fibrillation
title_fullStr Recent heart rate history affects QT interval duration in atrial fibrillation
title_full_unstemmed Recent heart rate history affects QT interval duration in atrial fibrillation
title_short Recent heart rate history affects QT interval duration in atrial fibrillation
title_sort recent heart rate history affects qt interval duration in atrial fibrillation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342318/
https://www.ncbi.nlm.nih.gov/pubmed/28273109
http://dx.doi.org/10.1371/journal.pone.0172962
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