Limb Lead Interchange in Thorough QT/QTc Studies

The investigators analyzed 85 133 electrocardiograms (ECGs) recorded in 484 subjects from 5 thorough QT/QTc studies (3 using Holter devices, 2 using 12‐lead ECGs) for inadvertent limb lead interchanges using a dedicated quality control process in a central ECG laboratory. Limb lead interchanges were...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical pharmacology 2011-10, Vol.51 (10), p.1468-1473
Main Authors: Salvi, Vaibhav, Karnad, Dilip R., Panicker, Gopi Krishna, Kothari, Snehal, Hingorani, Pooja, Natekar, Mili, Mahajan, Vaibhav, Narula, Dhiraj
Format: Article
Language:English
Subjects:
12-lead electrocardiograph
drug-induced QT prolongation
Electrocardiography
Electrocardiography - instrumentation
Electrodes
Heart Conduction System - physiology
Holter device
Humans
limb lead interchange
quality assurance
Quality control
Thorough QT/QTc study
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The investigators analyzed 85 133 electrocardiograms (ECGs) recorded in 484 subjects from 5 thorough QT/QTc studies (3 using Holter devices, 2 using 12‐lead ECGs) for inadvertent limb lead interchanges using a dedicated quality control process in a central ECG laboratory. Limb lead interchanges were present in 2919 (3.4%) ECGs in 17.9% of subjects and were more frequent with Holter devices (7.5% vs 0.8%, P < .0001), where leads remain connected for prolonged periods, affecting data from several time points. Left arm—left leg interchange was seen in 54% of 12‐lead ECGs and right arm—left arm interchange in 38%. The ECG device itself could identify 21.7% of interchanges, whereas experienced readers blinded to subject and visit identified 79% of interchanges; 21% of interchanges were identified only during the quality control process. If correctly identified, QT measurement could be performed in a precordial lead. If undiagnosed, incorrect QT interval measurements and morphological diagnosis may confound results.
ISSN:0091-2700
1552-4604
DOI:10.1177/0091270010383857