QT and RR interval analysis in genetic cardiac diseases using the AccuQT and advanced heart rate variability methods

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2025-11-01 Epub Date: 2025-08-24 DOI:10.1016/j.jelectrocard.2025.154098

Aliisa Lönnrot , Matias Kanniainen , Teemu Pukkila , Mary Vaarpu , Katriina Aalto-Setälä , Esa Räsänen

{"title":"QT and RR interval analysis in genetic cardiac diseases using the AccuQT and advanced heart rate variability methods","authors":"Aliisa Lönnrot , Matias Kanniainen , Teemu Pukkila , Mary Vaarpu , Katriina Aalto-Setälä , Esa Räsänen","doi":"10.1016/j.jelectrocard.2025.154098","DOIUrl":null,"url":null,"abstract":"<div><div>The QT interval is a key indicator in assessing arrhythmia risk, evaluating drug safety, and supporting clinical diagnosis in cardiology. The QT interval is significantly influenced by heart rate so it must be accurately corrected to ensure reliable clinical interpretation. Conventional correction formulas, such as Bazett's formula, are widely utilized but often criticized for inaccuracies, either under- or overcorrecting QT intervals in different physiological conditions. The recently developed AccuQT method, utilizing transfer entropy for QT correction, has demonstrated superior consistency in healthy populations and improved accuracy in diagnosing long QT syndrome (LQTS) compared to conventional approaches.</div><div>In this study, we evaluate the AccuQT method using 24-h Holter recordings from patients with various genetic heart diseases, including hypertrophic cardiomyopathy (HCM) and LQTS, compared to the healthy controls. Additionally, we analyzed heart rate variability with the recently developed scaled-dependent detrended fluctuation analysis (DFA).</div><div>The mean QTc using the AccuQT method in the patient group was significantly longer (476 ms) than in the healthy population (410 ms), as expected. The Bazett's formula resulted in significantly longer mean QTc in the healthy population (460 ms) and in patient group (490 ms). The DFA scaling exponent was lower at short scales for patient group compared to healthy controls. It also detected a difference between HCM patients with clinical disease and asymptomatic gene carriers with no signs of the disease.</div><div>In conclusion, the AccuQT method provides reliable QT interval correction in patients with genetic cardiac diseases, demonstrating superior precision compared to Bazett's formula. AccuQT effectively captures time-dependent QT interval changes, enhancing diagnostic accuracy. Additionally, scale-dependent DFA analysis shows promise in differentiating patients with clinical hypertrophic cardiomyopathy from asymptomatic gene carriers, suggesting potential utility in earlier identification of at-risk individuals.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154098"},"PeriodicalIF":1.5000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of electrocardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022073625002262","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

The QT interval is a key indicator in assessing arrhythmia risk, evaluating drug safety, and supporting clinical diagnosis in cardiology. The QT interval is significantly influenced by heart rate so it must be accurately corrected to ensure reliable clinical interpretation. Conventional correction formulas, such as Bazett's formula, are widely utilized but often criticized for inaccuracies, either under- or overcorrecting QT intervals in different physiological conditions. The recently developed AccuQT method, utilizing transfer entropy for QT correction, has demonstrated superior consistency in healthy populations and improved accuracy in diagnosing long QT syndrome (LQTS) compared to conventional approaches.

In this study, we evaluate the AccuQT method using 24-h Holter recordings from patients with various genetic heart diseases, including hypertrophic cardiomyopathy (HCM) and LQTS, compared to the healthy controls. Additionally, we analyzed heart rate variability with the recently developed scaled-dependent detrended fluctuation analysis (DFA).

The mean QTc using the AccuQT method in the patient group was significantly longer (476 ms) than in the healthy population (410 ms), as expected. The Bazett's formula resulted in significantly longer mean QTc in the healthy population (460 ms) and in patient group (490 ms). The DFA scaling exponent was lower at short scales for patient group compared to healthy controls. It also detected a difference between HCM patients with clinical disease and asymptomatic gene carriers with no signs of the disease.

In conclusion, the AccuQT method provides reliable QT interval correction in patients with genetic cardiac diseases, demonstrating superior precision compared to Bazett's formula. AccuQT effectively captures time-dependent QT interval changes, enhancing diagnostic accuracy. Additionally, scale-dependent DFA analysis shows promise in differentiating patients with clinical hypertrophic cardiomyopathy from asymptomatic gene carriers, suggesting potential utility in earlier identification of at-risk individuals.

查看原文本刊更多论文

使用AccuQT和高级心率变异性方法分析遗传性心脏病的QT和RR间期

QT间期是评估心律失常风险、评价药物安全性和支持临床诊断的关键指标。QT间期受心率显著影响，因此必须准确校正以确保可靠的临床解释。传统的校正公式，如Bazett公式，被广泛使用，但经常因不准确而受到批评，在不同的生理条件下，QT间期校正不足或过度。最近开发的AccuQT方法，利用转移熵进行QT校正，与传统方法相比，在健康人群中表现出优越的一致性，并提高了诊断长QT综合征（LQTS）的准确性。在这项研究中，我们使用包括肥厚性心肌病（HCM）和LQTS在内的各种遗传性心脏病患者的24小时动态心电图记录来评估AccuQT方法，并将其与健康对照进行比较。此外，我们分析了心率变异性与最近发展的尺度依赖的无趋势波动分析（DFA）。正如预期的那样，患者组使用AccuQT方法的平均QTc （476 ms）明显长于健康人群（410 ms）。Bazett公式导致健康人群（460 ms）和患者组（490 ms）的平均QTc显著延长。与健康对照组相比，患者组在短量表上的DFA评分指数较低。它还检测到有临床疾病的HCM患者和没有疾病迹象的无症状基因携带者之间的差异。总之，AccuQT方法为遗传性心脏病患者提供了可靠的QT间期校正，与Bazett公式相比，显示出更高的精确度。AccuQT有效捕获时间依赖性QT间期变化，提高诊断准确性。此外，依赖于量表的DFA分析显示有希望区分临床肥厚性心肌病患者和无症状基因携带者，这表明在早期识别高危个体方面具有潜在的效用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.