Abstract 15680: Validation of Remote Measurement of the Qtc Intervals Using an Apple Watch

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carmen Spaccarotella ◽  
serena migliarino ◽  
annalisa mongiardo ◽  
Jolanda Sabatino ◽  
Giuseppe Santarpia ◽  
...  

Introduction: In many circumstances, especially in the Covid-19 period, it could be necessary to measure the QT interval repeatedly even daily. Hypothesis: The aim of the study was to evaluate the feasibility of remote measuring LI-LII and V2 leads with using a commercially available Apple Watch Series 4. Methods: The accuracy of the QTc calculation with the smartwatch compared to the standard ECG was tested using di!erent formulae. One hundred patients admitted to our CCU were studied. LI-LII and V2 tracings were obtained immediately after the recording of the standard 12-lead ECG. The LI was recorded with the smartwatch on the left wrist and the right index finger on the crown; LII was obtained with the watch on the left lower abdomen and the right index finger on the crown; V2 lead was recorded with a smartwatch in the fourth intercostal space left parasternal with the right index finger on the crown. All recorded 30” ECGs were digitally stored using the health application of an iPhone Series 10 in the pdf format. The advantage of saving the ECG in pdf format is that it can be sent also via e-mail. Results: There was an agreement between the QTLI, QT-LII, QT-V2 and QT mean intervals of smartphone electrocardiography tracings and standard electrocardiography using Spearman’s correlation coefficient of 0.881; 0.885; 0.801; 0.911 respectively [p<0.001]. The reliability of the mean QTc measurements was tested with Bland-Altman analysis using Bazett’s, Friedericia’s, and Framingham’s formulas between standard ECG and smartwatch(Figure). Conclusions: These data demonstrated the feasibility to measure the QTc in LI, LII and V2 leads with a smartwatch with results comparable to that performed with the standard ECG. These data could have an important clinical impact both for the widespread di!usion of smartwatches and for the monitoring of drug-induced QT interval prolongation, especially in the Covid-19 era.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Carmen Anna Maria Spaccarotella ◽  
Serena Migliarino ◽  
Annalisa Mongiardo ◽  
Jolanda Sabatino ◽  
Giuseppe Santarpia ◽  
...  

AbstractThe inherited and acquired long QT is a risk marker for potential serious cardiac arrhythmias and sudden cardiac death. Smartwatches are becoming more popular and are increasingly used for monitoring human health. The present study aimed to assess the feasibility and reliability of evaluating the QT interval in lead I, lead II, and V2 lead using a commercially available Apple Watch. One hundred nineteen patients admitted to our Cardiology Division were studied. I, II, and V2 leads were obtained after recording a standard 12-lead ECG. Lead I was recorded with the smartwatch on the left wrist and the right index finger on the crown. Lead II was obtained with the smartwatch on the left lower abdomen and the right index finger on the crown. The V2 lead was recorded with the smartwatch in the fourth intercostal space left parasternal with the right index finger on the crown. There was agreement among the QT intervals of I, II, and V2 leads and the QT mean using the smartwatch and the standard ECG with Spearman’s correlations of 0.886; 0.881; 0.793; and 0.914 (p < 0.001), respectively. The reliability of the QTc measurements between standard and smartwatch ECG was also demonstrated with a Bland–Altman analysis using different formulas. These data show that a smartwatch can feasibly and reliably assess QT interval. These results could have an important clinical impact when frequent QT interval monitoring is required.


2013 ◽  
pp. 127-136
Author(s):  
Gianluca Airoldi

Acute agitation occurs in a variety of medical and psychiatric conditions, and the management of agitated, abusive, or violent patients is a common problem in the emergency department. Rapid control of potentially dangerous behaviors by physical restraint and pharmacologic tranquillization is crucial to ensure the safety of the patient and health-care personnel and to allow diagnostic procedures and treatment of the underlying condition. The purpose of this article (the first in a 2-part series) is to review the extensive safety data published on the antipsychotic medications currently available for managing situations of this type, including older neuroleptics like haloperidol, chlorpromazine, and pimozide as well as a number of the newer atypical antipsychotics (olanzapine, risperidone, ziprasidone). Particular attention is focused on the ability of these drugs to lengthen the QT interval in surface electrocardiograms. This adverse effect is of major concern, especially in light of the reported relation between QT interval and the risk of sudden death. In patients with the congenital long-QT syndrome, a long QT interval is associated with a fatal paroxysmal ventricular arrhythmia knownas torsades de pointes. Therefore, careful evaluation of the QT-prolonging properties and arrhythmogenic potential of antipsychotic drugs is urgently needed. Clinical assessment of drug-induced QT-interval prolongation is strictly dependent on the quality of electrocardiographic data and the appropriateness of electrocardiographic analyses. Unfortunately, measurement imprecision and natural variability preclude a simple use of the actually measured QT interval as a surrogate marker of drug-induced proarrhythmia. Because the QT interval changes with heart rate, a rate-corrected QT interval (QTc) is commonly used when evaluating a drug’s effect. In clinical settings, themost widely used formulas for rate-correction are those of Bazett (QTc=QT/RR^0.5) and Fridericia (QTc=QT/RR^0.33), both of which standardize themeasuredQTinterval to an RRinterval of 1 s (heart rate of 60 bpm).However, QT variability can also be influenced by other factors that are more difficult to measure, including body fat, meals, psycho-physical distress, and circadian and seasonal fluctuations.


2011 ◽  
Vol 4 (4) ◽  
pp. 223
Author(s):  
Torben K. Becker ◽  
Sai-Ching J. Yeung

Cancer patients are at an increased risk for QT interval prolongation and subsequent potentially fatal Torsade de pointes tachycardia due to the multiple drugs used for treatment of malignancies and the associated symptoms and complications. Based on a systematic review of the literature, this article analyzes the risk for prolongation of the QT interval with antineoplastic agents and commonly used concomitant drugs. This includes anthracyclines, fluorouracil, alkylating agents, and new molecularly targeted therapeutics, such as vascular disruption agents. Medications used in the supportive care can also prolong QT intervals, such as methadone, 5-HT3-antagonists and antihistamines, some antibiotics, antifungals, and antivirals. We describe the presumed mechanism of QT interval prolongation, drug-specific considerations, as well as important clinical interactions. Multiple risk factors and drug–drug interactions increase this risk for dangerous arrhythmias. We propose a systematic approach to evaluate cancer patients for the risk of QT interval prolongation and how to prevent adverse effects.


2015 ◽  
Vol 42 (6) ◽  
pp. 659-679 ◽  
Author(s):  
Eleonora Marostica ◽  
Karel Van Ammel ◽  
Ard Teisman ◽  
Koen Boussery ◽  
Jan Van Bocxlaer ◽  
...  

2008 ◽  
Vol 98 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Konstantinos P. Letsas ◽  
Michalis Efremidis ◽  
Stavros P. Kounas ◽  
Loukas K. Pappas ◽  
Gerasimos Gavrielatos ◽  
...  

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