Accuracy of four automatic QT measurement techniques in cardiac patients and healthy subjects.

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Abstract
OBJECTIVE: To assess differences in the accuracy of automatic QT measurement in three subject groups, and to determine the influence of T wave amplitude on these measurements. SUBJECTS: Standard simultaneous 12 lead electrocardiograms were acquired from 25 patients post myocardial infarction, 25 with arrhythmias, and 25 controls. DESIGN: Because there is not yet a standard automatic method for QT analysis, four different techniques were used. Manual QT measurements were used as the reference. QT was measured in two complexes by each technique in each lead, subject, and group. MAIN OUTCOME MEASURE: The differences between reference and automatic QT measurements from the three subject groups were compared independently for the four techniques. The T wave amplitudes for each of the groups were also compared. RESULTS: Variability of the automatic QT measurements, relative to the manual reference, in the cardiac patients was 2.1 times that in the controls (P < 0.005). Mean T wave amplitude was lower (by a factor of two) for the cardiac patients compared with the controls (P < 0.01). No simple relation between T wave amplitude and the difference between automatic and manual QT measurements was found, although the difference was 2.2 times greater for absolute T wave amplitudes of less than 0.25 mV (P < 0.001). CONCLUSIONS: Automatic QT measurement techniques are less accurate in cardiac patients than in controls. Measurements from T waves with amplitudes less than 0.25 mV are less reliable.