Abstract
Cardiac repolarization is assessed by the QT interval on the surface electrocardiogram and varies with the heart rate. Standard QT corrections (QTc) do not account for the lag in QT change following a change in heart rate (QT hysteresis). Our group has developed and tested a transfer function (TRF) model to assess the effectiveness of a dynamic model of QT/RR coupling in eliminating hysteresis. We studied three groups: group I, healthy volunteers (n = 23, 41 ± 17 years); group II, hypertensive patients (n = 25, 45 ± 11 years); and group III, patients in a predominately paced rhythm (n = 5, 75 ± 6 years). To vary the heart rate, either exercise bicycling in the supine position (groups I and II) or manipulation of the pacemaker parameters (group III) was done. We then compared a dynamic TRF model with a model based on weighted averages of previous RR intervals. Two parameters were tested: root mean square (RMS) of the error signal between measured and computed QT and the elimination of hysteretic loops. TRF-based measurements eliminated hysteresis in 22/23 (95%) group I patients, 21/25 (84%) group II patients, and 4/5 (80%) group III patients. When hysteresis elimination was not complete, the QT drift that followed RR intervals w...Continue Reading
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