Circadian variation of QT interval dispersion: correlation with heart rate variability

The circadian variation of QT interval dispersion and its correlation with heart rate variability (HRV) was examined in 17 normal subjects by using 24-hour recordings of three-lead electrocardiograms. Measurements of HRV, R-R intervals, and QT intervals were made for the first 6 minutes of each hour over a 24-hour period. Spectral analysis of HRV yielded low-frequency power (LF) (0.04-0.15 Hz), high-frequency power (HF) (0.15-0.40 Hz), and the ratio of LF to HF (LF/HF). A rate-corrected QT interval (QTc) was calculated by Bazett's formula, and QT and QTc dispersion was defined as the difference between the maximum and minimum values in any two leads. High-frequency power and QT interval were greater at night than during the day: conversely, LF/HF and dispersion of QT and QTc were greater during the day. The QTc interval remained virtually unchanged throughout the 24-hour period. The dispersion of QTc showed a significant negative correlation with HF and a significant positive correlation with LF/HF. The results suggest that an increased sympathetic tone or a decreased vagal tone increases QT dispersion in healthy subjects.