Cut-Offs for Screening Prolonged QT Intervals From Fridericias Formula in Children and Adolescents
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概要
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Background: The corrected QT interval (QTc) according to Bazetts formula (QTc = QT/RR1/2) has been used in clinical practice. Bazetts formula, however, overcorrects the QT interval at fast heart rates and undercorrects it at low heart rates. Guidelines and some investigators have recommended using Fridericias formula (QTc = QT/RR1/3) in these cases, especially in tachycardic subjects. The aim of the present study was to determine cut-offs for QTc suitable for screening pediatric subjects with prolonged QT intervals, based on manually measured values corrected by Fridericias formula in a large number of subjects. Methods and Results: Three consecutive QT and RR intervals were measured in 4,655, 4,655, and 5,273 1st, 7th, and 10th graders, aged 6, 12, and 15 years, respectively. Each QT interval was corrected by Fridericias formula, and mean values were calculated. Determination of the cut-offs for screening was based on the prevalence of abnormal electrocardiographic phenotypes of 1:1,164 and on the upper 0.025 percentile in the QTc distribution derived from previous studies. The tentative cut-offs suitable for screening subjects with prolonged QT intervals were 430 ms for 1st graders, 445 ms for 7th graders, and 440 and 455 ms for 10th grade boys and girls, respectively. Conclusions: These tentative cut-offs can be used to screen subjects with prolonged QT intervals in the clinical setting. Further studies are needed to confirm their validity.
著者
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Tanaka Yuji
Department of Molecular and Functional Genomics, Center for Integrated Research in Science, Shimane
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Hazeki Daisuke
Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
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Yoshinaga Masao
Department of Pediatrics, National Hospital Organization Kagoshima Medical Center
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Takahashi Hideto
Department of Epidemiology and Biostatistics, School of Medicine, University of Tsukuba
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Haraguchi Yasue
Division of Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagosh
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Abe Mayumi
Department of Laboratory Medicine, National Hospital Organization Kagoshima Medical Center
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Koga Masami
Department of Laboratory Medicine, National Hospital Organization Kagoshima Medical Center
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Fukushige Toshiro
Department of Pediatrics, Prefectural Hokusatsu Hospital
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Nagashima Masami
Aichi Childrens Health and Medical Center
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