Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG
ABSTRACT QT/QTc prolongation is associated with an increased risk for torsade de pointes. In at‐risk hospitalized patients, it is common to obtain a standard 12‐lead electrocardiogram (ECG) for this assessment, but this interrupts patient care. Our hospital recently introduced bedside monitors in th...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Annals of Noninvasive Electrocardiology |
| Online Access: | https://doi.org/10.1111/anec.70031 |
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| _version_ | 1832583765368504320 |
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| author | Arthur Murray Karolina Ho Thomas J. Hoffmann Gopika K. Ganesh Shelvin Prasad Sarah Berger Cass Sandoval Amy Larsen Hildy Schell‐Chaple Michele M. Pelter |
| author_facet | Arthur Murray Karolina Ho Thomas J. Hoffmann Gopika K. Ganesh Shelvin Prasad Sarah Berger Cass Sandoval Amy Larsen Hildy Schell‐Chaple Michele M. Pelter |
| author_sort | Arthur Murray |
| collection | DOAJ |
| description | ABSTRACT QT/QTc prolongation is associated with an increased risk for torsade de pointes. In at‐risk hospitalized patients, it is common to obtain a standard 12‐lead electrocardiogram (ECG) for this assessment, but this interrupts patient care. Our hospital recently introduced bedside monitors in the intensive care unit (ICU) with continuous QT/QTc software. However, only four of the seven available ECG leads are used. Purpose Evaluate the agreement between computerized QT/QTc measurements from the bedside monitor (four leads) and a time‐matched standard 12‐lead ECG. Design Prospective observational study in three adult ICUs. Methods QT/QTc measurements were obtained from a convenience sample, and the two ECG types were ≤ 30 min apart. Agreement was evaluated using Bland–Altman analysis. Results A total of 120 patients were evaluated for inclusion, and 60 (50%) had a 12‐lead ECG for comparison. The mean bias difference for QT measurements was not statistically different (β = −2.47, 95% CI = 5.50 to −11.05; p = 0.44; limits of agreement (LOA) = −64.37 to 59.44). Similar non‐statistical differences were observed for QTc (β = −3.20, 95% CI = 5.50 to −11.05; p = 0.44; LOA = −67.43 to 61.03). Conclusion There was good agreement for both QT and QTc measurements between the two methods. These pilot data are promising and suggest QT/QTc measurements from bedside monitors (four leads) may be an acceptable alternative to obtaining additional standard 12‐lead ECGs. Given that half of the ICU patients screened did not have a 12‐lead ECG recorded, bedside monitor QT/QTc's could identify at‐risk patients. However, an evaluation in a larger sample and non‐ICU patients is warranted. |
| format | Article |
| id | doaj-art-1ca2d28f9bcc4a2abb94adfbca0289b6 |
| institution | Kabale University |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-1ca2d28f9bcc4a2abb94adfbca0289b62025-01-28T05:38:41ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-01-01301n/an/a10.1111/anec.70031Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECGArthur Murray0Karolina Ho1Thomas J. Hoffmann2Gopika K. Ganesh3Shelvin Prasad4Sarah Berger5Cass Sandoval6Amy Larsen7Hildy Schell‐Chaple8Michele M. Pelter9Benioff Children's Hospital‐Oakland Oakland California USAUCSF Health University of California San Francisco California USAEpidemiology and Biostatistics, School of Medicine and Office of Research, School of Nursing University of California San Francisco San Francisco California USAKaiser Permanente San Rafael California USAUCSF Health University of California San Francisco California USAAdult Critical Care, UCSF Health University of California San Francisco California USAAdult Critical Care, UCSF Health University of California San Francisco California USAAdult Critical Care, UCSF Health University of California San Francisco California USACenter for Nursing Excellence & Innovation, UCSF Health University of California San Francisco San Francisco California USAECG Monitoring Research Lab, Department of Physiological Nursing, School of Nursing University of California San Francisco San Francisco California USAABSTRACT QT/QTc prolongation is associated with an increased risk for torsade de pointes. In at‐risk hospitalized patients, it is common to obtain a standard 12‐lead electrocardiogram (ECG) for this assessment, but this interrupts patient care. Our hospital recently introduced bedside monitors in the intensive care unit (ICU) with continuous QT/QTc software. However, only four of the seven available ECG leads are used. Purpose Evaluate the agreement between computerized QT/QTc measurements from the bedside monitor (four leads) and a time‐matched standard 12‐lead ECG. Design Prospective observational study in three adult ICUs. Methods QT/QTc measurements were obtained from a convenience sample, and the two ECG types were ≤ 30 min apart. Agreement was evaluated using Bland–Altman analysis. Results A total of 120 patients were evaluated for inclusion, and 60 (50%) had a 12‐lead ECG for comparison. The mean bias difference for QT measurements was not statistically different (β = −2.47, 95% CI = 5.50 to −11.05; p = 0.44; limits of agreement (LOA) = −64.37 to 59.44). Similar non‐statistical differences were observed for QTc (β = −3.20, 95% CI = 5.50 to −11.05; p = 0.44; LOA = −67.43 to 61.03). Conclusion There was good agreement for both QT and QTc measurements between the two methods. These pilot data are promising and suggest QT/QTc measurements from bedside monitors (four leads) may be an acceptable alternative to obtaining additional standard 12‐lead ECGs. Given that half of the ICU patients screened did not have a 12‐lead ECG recorded, bedside monitor QT/QTc's could identify at‐risk patients. However, an evaluation in a larger sample and non‐ICU patients is warranted.https://doi.org/10.1111/anec.70031 |
| spellingShingle | Arthur Murray Karolina Ho Thomas J. Hoffmann Gopika K. Ganesh Shelvin Prasad Sarah Berger Cass Sandoval Amy Larsen Hildy Schell‐Chaple Michele M. Pelter Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG Annals of Noninvasive Electrocardiology |
| title | Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG |
| title_full | Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG |
| title_fullStr | Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG |
| title_full_unstemmed | Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG |
| title_short | Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12‐Lead ECG |
| title_sort | computerized qt and qtc measurements from bedside icu monitors are similar to those derived from a standard 12 lead ecg |
| url | https://doi.org/10.1111/anec.70031 |
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