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Automated T-wave analysis can differentiate acquired QT prolongation from congenital long QT syndrome
A. Sugrue, PA. Noseworthy, V. Kremen, JM. Bos, B. Qiang, RK. Rohatgi, Y. Sapir, ZI. Attia, P. Brady, PJ. Caraballo, SJ. Asirvatham, PA. Friedman, MJ. Ackerman,
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
Medline Complete (EBSCOhost) od 2004-01-01
Wiley-Blackwell Open Access Titles od 1997
ROAD: Directory of Open Access Scholarly Resources od 1996
Odkazy
PubMed
28429460
DOI
10.1111/anec.12455
Knihovny.cz E-zdroje
- MeSH
- diferenciální diagnóza MeSH
- elektrokardiografie metody MeSH
- lidé MeSH
- mladiství MeSH
- retrospektivní studie MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- syndrom dlouhého QT vrozené diagnóza patofyziologie MeSH
- Check Tag
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Prolongation of the QT on the surface electrocardiogram can be due to either genetic or acquired causes. Distinguishing congenital long QT syndrome (LQTS) from acquired QT prolongation has important prognostic and management implications. We aimed to investigate if quantitative T-wave analysis could provide a tool for the physician to differentiate between congenital and acquired QT prolongation. METHODS: Patients were identified through an institution-wide computer-based QT screening system which alerts the physician if the QTc ≥ 500 ms. ECGs were retrospectively analyzed with an automated T-wave analysis program. Congenital LQTS was compared in a 1:3 ratio to those with an identified acquired etiology for QT prolongation (electrolyte abnormality and/or prescription of known QT prolongation medications). Linear discriminant analysis was performed using 10-fold cross-validation to statistically test the selected features. RESULTS: The 12-lead ECG of 38 patients with congenital LQTS and 114 patients with drug-induced and/or electrolyte-mediated QT prolongation were analyzed. In lead V5 , patients with acquired QT prolongation had a shallower T wave right slope (-2,322 vs. -3,593 mV/s), greater T-peak-Tend interval (109 vs. 92 ms), and smaller T wave center of gravity on the x axis (290 ms vs. 310 ms; p < .001). These features could distinguish congenital from acquired causes in 77% of cases (sensitivity 90%, specificity 58%). CONCLUSION: T-wave morphological analysis on lead V5 of the surface ECG could successfully differentiate congenital from acquired causes of QT prolongation.
Department of Cardiovascular Diseases Division of Heart Rhythm Services Mayo Clinic Rochester MN USA
Department of Internal Medicine Mayo Clinic Rochester MN USA
Electrical and Computer Engineering Ben Gurion University of the Negev Beer Sheva Israel
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- $a Sugrue, Alan $u Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. Department of Cardiovascular Diseases, Division of Heart Rhythm Services, Mayo Clinic, Rochester, MN, USA.
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- $a BACKGROUND: Prolongation of the QT on the surface electrocardiogram can be due to either genetic or acquired causes. Distinguishing congenital long QT syndrome (LQTS) from acquired QT prolongation has important prognostic and management implications. We aimed to investigate if quantitative T-wave analysis could provide a tool for the physician to differentiate between congenital and acquired QT prolongation. METHODS: Patients were identified through an institution-wide computer-based QT screening system which alerts the physician if the QTc ≥ 500 ms. ECGs were retrospectively analyzed with an automated T-wave analysis program. Congenital LQTS was compared in a 1:3 ratio to those with an identified acquired etiology for QT prolongation (electrolyte abnormality and/or prescription of known QT prolongation medications). Linear discriminant analysis was performed using 10-fold cross-validation to statistically test the selected features. RESULTS: The 12-lead ECG of 38 patients with congenital LQTS and 114 patients with drug-induced and/or electrolyte-mediated QT prolongation were analyzed. In lead V5 , patients with acquired QT prolongation had a shallower T wave right slope (-2,322 vs. -3,593 mV/s), greater T-peak-Tend interval (109 vs. 92 ms), and smaller T wave center of gravity on the x axis (290 ms vs. 310 ms; p < .001). These features could distinguish congenital from acquired causes in 77% of cases (sensitivity 90%, specificity 58%). CONCLUSION: T-wave morphological analysis on lead V5 of the surface ECG could successfully differentiate congenital from acquired causes of QT prolongation.
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