Viskin Sami, Rosovski Uri, Sands Andrew J, Chen Edmond, Kistler Peter M, Kalman Jonathan M, Rodriguez Chavez Laura, Iturralde Torres Pedro, Cruz F Fernando E S, Centurión Osmar A, Fujiki Akira, Maury Philippe, Chen Xiaomin, Krahn Andrew D, Roithinger Franz, Zhang Li, Vincent G Michael, Zeltser David
Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Heart Rhythm. 2005 Jun;2(6):569-74. doi: 10.1016/j.hrthm.2005.02.011.
Physicians in all fields of medicine may encounter patients with long QT syndrome (LQTS). It is important to define the percentage of physicians capable of distinguishing QT intervals that are long from those that are normal because LQTS can be lethal when left untreated.
The purpose of this study was to define the percentage of physicians in the different disciplines of medicine who can recognize a long QT when they see one.
We presented the ECGs of two patients with LQTS and two healthy females to 902 physicians (25 world-renowned QT experts, 106 arrhythmia specialists, 329 cardiologists, and 442 noncardiologists) from 12 countries. They were asked to measure the QT, calculate the QTc (the QT interval corrected for the heart rate), and determine whether the QT is normal or prolonged.
For patients with LQTS, >80% of arrhythmia experts but <50% of cardiologists and <40% of noncardiologists calculated the QTc correctly. Underestimation of the QTc of patients with LQTS and overestimation of the QTc of healthy patients were common. Interobserver agreement was excellent among QT experts, moderate among arrhythmia experts, and low among cardiologists and noncardiologists (kappa coefficient = 0.82, 0.44, and < 0.3, respectively). Correct classification of all QT intervals as either "long" or "normal" was achieved by 96% of QT experts and 62% of arrhythmia experts, but by only <25% of cardiologists and noncardiologists.
Most physicians, including many cardiologists, cannot accurately calculate a QTc and cannot correctly identify a long QT.
各个医学领域的医生都可能遇到长QT综合征（LQTS）患者。确定能够区分长QT间期与正常QT间期的医生比例非常重要，因为LQTS若不治疗可能会致命。
本研究的目的是确定不同医学学科中能够识别长QT的医生比例。
我们向来自12个国家的902名医生（25名世界知名的QT专家、106名心律失常专家、329名心脏病专家和442名非心脏病专家）展示了两名LQTS患者和两名健康女性的心电图。要求他们测量QT、计算QTc（根据心率校正的QT间期），并确定QT是否正常或延长。
对于LQTS患者，超过80%的心律失常专家能正确计算QTc，但心脏病专家中只有不到50%，非心脏病专家中只有不到40%能正确计算。对LQTS患者的QTc低估以及对健康患者的QTc高估很常见。QT专家之间的观察者间一致性良好，心律失常专家之间为中等，心脏病专家和非心脏病专家之间较低（kappa系数分别为0.82、0.44和<0.3）。96%的QT专家和62%的心律失常专家能将所有QT间期正确分类为“长”或“正常”，但心脏病专家和非心脏病专家中只有不到25%能做到。
大多数医生，包括许多心脏病专家，不能准确计算QTc，也不能正确识别长QT。
