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Updated: Jan 23, 2026

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QT Corrections for Long QT Risk Assessment: Implications for the Preparticipation Examination

David Hadley1, David Hsu2, David Pickham3

  • 1Cardiac Insight Inc, Seattle, Washington.

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
|June 27, 2019
PubMed

Insights

New QT interval screening thresholds are proposed for young athletes to better detect inherited arrhythmic diseases and prevent sudden cardiac death (SCD). The Fridericia correction formula is recommended over Bazett for improved accuracy in ECG screening.

Area of Science:

  • Cardiology
  • Sports Medicine
  • Genetics

Background:

  • Sudden cardiac death (SCD) in young individuals often occurs in hearts without structural abnormalities.
  • Current screening for inherited arrhythmic diseases relies on QT interval measurements with outdated criteria.
  • Improved electrocardiogram (ECG) screening methods are crucial for identifying at-risk youth.

Purpose of the Study:

  • Define normal upper limits for QT interval in healthy young individuals.
  • Compare the efficacy of different QT interval correction formulas.
  • Propose new QT interval thresholds for SCD risk stratification in young populations.

Main Methods:

  • Analysis of ECG data from 31,558 young active individuals undergoing preparticipation physical examinations.
  • Comparison of Bazett and Fridericia correction formulas for QT interval measurement.
  • Statistical analysis to determine optimal screening thresholds.

Main Results:

  • The Fridericia correction formula demonstrated superior performance in removing heart rate effects and fitting raw data compared to Bazett.
  • Using Fridericia correction increased the detection rate of athletes in the 99th/99.5th percentiles by over 50% compared to Bazett.
  • The study analyzed data from a large cohort of young athletes across different age groups.

Conclusions:

  • The Fridericia correction formula is recommended for QT interval assessment in preparticipation examinations.
  • Proposed thresholds are 460 ms for men and 470 ms for women, with 485 ms for marked prolongation.
  • These updated criteria enhance the detection of individuals at risk for SCD.
Abstract

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