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García-Izquierdo E, García-Gómez S, Aguilera-Agudo C, De Castro-Campos D, García-Rodríguez D, Fajardo-Simón L, Veloza-Urrea D, Segura-Domínguez M, Jiménez-Sánchez D, Castro-Urda V, Toquero-Ramos J, Fernández-Lozano I. Estimation of the QTc interval in the presence of right bundle branch block: A comparative study using validated formulae for left bundle branch block. J Electrocardiol 2022; 74:26-31. [PMID: 35917620 DOI: 10.1016/j.jelectrocard.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adequate measurement of the QT interval is of clinical importance in order to identify patients at higher risk for ventricular arrhythmias. Previous studies have described different methods to estimate baseline QT in patients with left bundle branch block (LBBB). However, the evidence regarding the assessment of the QT in patients with right bundle branch block (RBBB) is scarce. AIM To analyze the feasibility and reliability of the different formulae described for LBBB in the estimation of the baseline QT in the presence of RBBB. METHODS We performed an observational study including patients who underwent electrophysiology study and/or ablation. Two types of RBBB were considered: 1) pacing-induced and 2) transient true RBBB. QRS, JT and QT intervals were measured during baseline and RBBB. Estimated QTc was calculated using LBBB formulae: Bogossian, Rautaharju, Tabatabaei, Tang-Rabkin, Yankelson, Wang. Linear correlation and intraclass correlation coefficients (ICC) were used to assess the reliability of these formulae for the estimation of baseline QTc. RESULTS We finally included a total of 100 patients. Correlations between baseline and estimated QTc were strong (R > 0.7) for all the formulae except for Tabatabaei. Yankelson and Wang showed the highest reliability (ICC = 0.775 and 0.727, respectively). Yankelson appeared to be the most accurate formula, with a mean estimated QTc closest to baseline values. CONCLUSION Previously described formulae for LBBB exhibited marked differences regarding reliability in the estimation of the QTc interval in the presence of RBBB. According to our results, Yankelson showed the most consistent and accurate agreement in this setting.
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Affiliation(s)
- Eusebio García-Izquierdo
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain.
| | - Sergio García-Gómez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Cristina Aguilera-Agudo
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Daniel De Castro-Campos
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Daniel García-Rodríguez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Lourdes Fajardo-Simón
- Psychiatry Unit, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Darwin Veloza-Urrea
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Melodie Segura-Domínguez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Diego Jiménez-Sánchez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Victor Castro-Urda
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Jorge Toquero-Ramos
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
| | - Ignacio Fernández-Lozano
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Puerta de Hierro, Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain
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