Conventional QT variability measurement vs. template matching techniques: comparison of performance using simulated and real ECG

Increased beat-to-beat variability in the QT interval (QTV) of ECG has been associated with increased risk for sudden cardiac death, but its measurement is technically challenging and currently not standardized. The aim of this study was to investigate the performance of commonly used beat-to-beat Q...

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Bibliographic Details
Published in:PloS one 2012-07, Vol.7 (7), p.e41920-e41920
Main Authors: Baumert, Mathias, Starc, Vito, Porta, Alberto
Format: Article
Language:English
Subjects:
Algorithms
Amplitude modulation
Anti-Arrhythmia Agents - pharmacology
Biology
Broadband
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Comparative analysis
Computer Simulation
Echocardiography - methods
Echocardiography - standards
Electrocardiography
Engineering
Heart
Heart diseases
Heart rate
Humans
Infusion
Medicine
Methods
Models, Biological
Myocardial Contraction - drug effects
Noise
Prolongation
Recording
Reproducibility of Results
Retrospective Studies
Signal-To-Noise Ratio
Sotalol - pharmacology
Template matching
Variability
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Summary:Increased beat-to-beat variability in the QT interval (QTV) of ECG has been associated with increased risk for sudden cardiac death, but its measurement is technically challenging and currently not standardized. The aim of this study was to investigate the performance of commonly used beat-to-beat QT interval measurement algorithms. Three different methods (conventional, template stretching and template time shifting) were subjected to simulated data featuring typical ECG recording issues (broadband noise, baseline wander, amplitude modulation) and real short-term ECG of patients before and after infusion of sotalol, a QT interval prolonging drug. Among the three algorithms, the conventional algorithm was most susceptible to noise whereas the template time shifting algorithm showed superior overall performance on simulated and real ECG. None of the algorithms was able to detect increased beat-to-beat QT interval variability after sotalol infusion despite marked prolongation of the average QT interval. The QTV estimates of all three algorithms were inversely correlated with the amplitude of the T wave. In conclusion, template matching algorithms, in particular the time shifting algorithm, are recommended for beat-to-beat variability measurement of QT interval in body surface ECG. Recording noise, T wave amplitude and the beat-rejection strategy are important factors of QTV measurement and require further investigation.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0041920