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Vectorcardiographic Recordings of the Q-T Interval in a Pediatric Long Q-T Syndrome Population

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Abstract

Measurements of the Q-T interval are less reliable in children than in adults. Identification of superior diagnostic tools is warranted. This study aimed to investigate whether a vectorcardiogram (VCG) recorded from three orthogonal leads (X, Y, Z) according to Frank is superior to a 12-lead electrocardiogram (ECG) in providing a correct long Q-T syndrome (LQTS) diagnosis in children. This LQTS group consisted of 35 genetically confirmed carriers of mutations in the KCNQ1 (n = 29) and KCNH2 (n = 6) genes. The control group consisted of 35 age- and gender-matched healthy children. The mean age was 7 years in the LQTS group and 6.7 years in the control group (range, 0.5–16 years). The corrected Q-T interval (QTc) was measured manually (QTman) by one author (A.W.). The 12-lead ECG automatic measurements (QTECG) and interpretation (QTInterpret) of QTc were performed with the Mac5000 (GE Medical System), and the VCG automatic measurements (QTVCG) were performed with the Mida1000, CoroNet (Ortivus AB, Sweden). By either method, a QTc longer than 440 ms was considered prolonged and indicative of LQTS. Of the 35 children with genetically confirmed LQTS, 30 (86 %) received a correct diagnosis using QTVCG, 29 (82 %) using QTman, 24 (69 %) using QTECG, and 17 (49 %) using QTInterpret. Specificity was 0.80 for QTVCG, 0.83 for QTman, 0.77 for QTECG, and 0.83 for QTInterpret. The VCG automatic measurement of QTc seems to be a better predictor of LQTS than automatic measurement and interpretation of 12-lead ECG.

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Acknowledgments

The Swedish Heart-Lung Foundation, the Northern County Councils Cooperation Committee, and the Heart Foundation of Northern Sweden provided financial support for this research.

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Author notes

  1. Eva-Lena Stattin

    Present address: Cardiovascular Genetics, Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA

Authors and Affiliations

  1. Department of Public Health and Clinical Medicine, Heart Centre, Umeå University, 90185, Umeå, Sweden

    Ulla-Britt Diamant & Steen M. Jensen

  2. Department of Clinical Sciences Pediatrics, Umeå University, Umeå, Sweden

    Annika Winbo & Annika Rydberg

  3. Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, Sweden

    Eva-Lena Stattin

Authors
  1. Ulla-Britt Diamant
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  2. Steen M. Jensen
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  3. Annika Winbo
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  4. Eva-Lena Stattin
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  5. Annika Rydberg
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Correspondence to Ulla-Britt Diamant.

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Diamant, UB., Jensen, S.M., Winbo, A. et al. Vectorcardiographic Recordings of the Q-T Interval in a Pediatric Long Q-T Syndrome Population. Pediatr Cardiol 34, 245–249 (2013). https://doi.org/10.1007/s00246-012-0425-2

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  • DOI: https://doi.org/10.1007/s00246-012-0425-2

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