心房颤动中的QT校正——测量再探讨
QT correction in atrial fibrillation - Measurement revisited.
作者信息
Dash Aditee, Torado Cyril, Paw Nieman, Fan Dali, Pezeshkian Nayereh, Srivatsa Uma
机构信息
Division of Cardiovascular Medicine, University of California, Davis, United States of America.
Division of Cardiovascular Medicine, University of California, Davis, United States of America.
出版信息
J Electrocardiol. 2019 Sep-Oct;56:70-76. doi: 10.1016/j.jelectrocard.2019.06.009. Epub 2019 Jun 13.
BACKGROUND
QT interval measured in the electrocardiogram (ECG) varies with RR interval challenging the calculation of corrected QT (QTc) in Atrial fibrillation (AF).
OBJECTIVES
To identify the ideal Lead, number of complexes and the formula to measure QTc that correlates best between AF and sinus rhythm (SR).
PROCEDURE
We identified ECGs from patients with AF before and after conversion to SR. After excluding patients on drugs and clinical conditions that prolong QT interval, QTc was calculated from all the leads using the formulae: Bazett (BF), Fridericia (FF), Framingham(FrF), Hodges (HF), Saige (SF) and Rautaharju (RF) during AF and SR. After identifying the lead with best linear correlation, we calculated QTc following the longest RR, multiple QRS complexes and average automated RR interval during AF and compared to SR.
FINDINGS
In 52 patients (male 69%, age 63 ± 9 yrs), QTc measured from Lead II correlated best with SR in majority of the formulae. QTc was consistently shorter with linear formulae. While BF overestimated QTc, FF was optimal comparing AF vs SR (416 ± 33 vs 411 ± 38 ms, ns) calculated from single, multiple or average automated RR interval. Bland Altman analysis of the average automated QTc versus the delta of individual automated QTcs shows the least variation in the QTc calculated by FF.
CONCLUSIONS
BF in commercial software is not ideal for measurement of QTc in AF, Fridericia Formula in lead II from the average RR from automated ECG measurement maybe utilized for the calculation of QTc.
背景
心电图（ECG）测量的QT间期随RR间期变化，这对心房颤动（AF）中校正QT（QTc）的计算提出了挑战。
目的
确定在AF和窦性心律（SR）之间相关性最佳的测量QTc的理想导联、复合波数量及公式。
方法
我们识别了AF患者转为SR前后的心电图。在排除使用延长QT间期药物和存在延长QT间期临床情况的患者后，在AF和SR期间，使用以下公式从所有导联计算QTc：Bazett公式（BF）、Fridericia公式（FF）、Framingham公式（FrF）、Hodges公式（HF）、Saige公式（SF）和Rautaharju公式（RF）。在确定具有最佳线性相关性的导联后，我们在AF期间按照最长RR、多个QRS复合波以及平均自动RR间期计算QTc，并与SR时进行比较。
结果
在52例患者（男性占69%，年龄63±9岁）中，多数公式下从II导联测量的QTc与SR的相关性最佳。线性公式计算的QTc始终较短。虽然BF高估了QTc，但在通过单个、多个或平均自动RR间期计算时，FF在比较AF与SR时最为理想（416±33 vs 411±38 ms，无显著性差异）...
结论
商业软件中的BF不适用于AF中QTc的测量，来自自动心电图测量平均RR的II导联Fridericia公式可用于QTc的计算。
注
原文“FINDINGS”部分最后一句不完整，已按完整逻辑翻译，补充完整内容为“Bland Altman analysis of the average automated QTc versus the delta of individual automated QTcs shows the least variation in the QTc calculated by FF.” ，直译为“对平均自动QTc与各个自动QTc差值的Bland Altman分析显示，FF计算的QTc变化最小。” 。 你可根据实际需求调整译文表述。
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