Fast, accurate and easy-to-teach QT interval assessment: The triplicate concatenation method

Area of Science:

• Cardiology
• Electrocardiography
• Pharmacology

Background:

• The standard QTcF semiautomated triplicate averaging method (TAM) is time-consuming for assessing QTcF intervals.
• A novel QTcF semiautomated triplicate concatenation method (TCM) has been developed for QTcF interval assessment.

Purpose of the Study:

• To compare the accuracy and efficiency of the novel TCM with the established TAM method.
• To evaluate inter-reader agreement between an expert and a student using both TAM and TCM.

Main Methods:

• Fifty triplicate electrocardiograms were analyzed by an expert and a student using both TAM and TCM.
• Bland-Altman plots were used to assess agreement between methods and readers.
• Reading time for 20 consecutive triplicate electrocardiogram sets was recorded.

Main Results:

• QTcF measurements using TAM and TCM showed good agreement, with limits of agreement of -8.25 to 6.75ms for expert readers.
• TCM was approximately twice as fast as TAM, reducing reading time for 20 sets from 34.28 to 17.38 minutes.
• Inter-reader agreement was higher with TCM (-1.2 to 8.0ms) compared to TAM (-4.34 to 11.75ms).

Conclusions:

• The TCM method provides accurate QT interval measurements comparable to TAM.
• TCM offers a significant time-saving advantage over TAM for QTcF interval assessment.
• Inexperienced readers can achieve accurate QT interval measurements with both methods after a brief learning period.