Computerized QT and QTc Measurements From Bedside ICU Monitors Are Similar to Those Derived From a Standard 12-Lead ECG.

Autor: Murray A; Benioff Children's Hospital-Oakland, Oakland, California, USA., Ho K; UCSF Health, University of California, San Francisco, California, USA., Hoffmann TJ; Epidemiology and Biostatistics, School of Medicine and Office of Research, School of Nursing, University of California San Francisco, San Francisco, California, USA., Ganesh GK; Kaiser Permanente, San Rafael, California, USA., Prasad S; UCSF Health, University of California, San Francisco, California, USA., Berger S; Adult Critical Care, UCSF Health, University of California, San Francisco, California, USA., Sandoval C; Adult Critical Care, UCSF Health, University of California, San Francisco, California, USA., Larsen A; Adult Critical Care, UCSF Health, University of California, San Francisco, California, USA., Schell-Chaple H; Center for Nursing Excellence & Innovation, UCSF Health, University of California San Francisco, San Francisco, California, USA., Pelter MM; ECG Monitoring Research Lab, Department of Physiological Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc [Ann Noninvasive Electrocardiol] 2025 Jan; Vol. 30 (1), pp. e70031.
DOI: 10.1111/anec.70031
Abstrakt: 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.
(© 2024 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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