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QT Values (qt + value)
Selected AbstractsPhilips QT Interval Measurement Algorithms for Diagnostic, Ambulatory, and Patient Monitoring ECG ApplicationsANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2009F.A.C.C., Sophia H. Zhou Ph.D. Background: Commonly used techniques for QT measurement that identify T wave end using amplitude thresholds or the tangent method are sensitive to baseline drift and to variations of terminal T wave shape. Such QT measurement techniques commonly underestimate or overestimate the "true" QT interval. Methods: To find the end of the T wave, the new Philips QT interval measurement algorithms use the distance from an ancillary line drawn from the peak of the T wave to a point beyond the expected inflection point at the end of the T wave. We have adapted and optimized modifications of this basic approach for use in three different ECG application areas: resting diagnostic, ambulatory Holter, and in-hospital patient monitoring. The Philips DXL resting diagnostic algorithm uses an alpha-trimming technique and a measure of central tendency to determine the median QT value of eight most reliable leads. In ambulatory Holter ECG analysis, generally only two or three channels are available. QT is measured on a root-mean-square vector magnitude signal. Finally, QT measurement in the real time in-hospital application is among the most challenging areas of QT measurement. The Philips real time QT interval measurement algorithm employs features from both Philips DXL 12-lead and ambulatory Holter QT algorithms with further enhancements. Results: The diagnostic 12-lead algorithm has been tested against the gold standard measurement database established by the CSE group with results surpassing the industrial ECG measurement accuracy standards. Holter and monitoring algorithm performance data on the PhysioNet QT database were shown to be similar to the manual measurements by two cardiologists. Conclusion: The three variations of the QT measurement algorithm we developed are suitable for diagnostic 12-lead, Holter, and patient monitoring applications. [source] Comparing Methods of Measurement for Detecting Drug-Induced Changes in the QT Interval: Implications for Thoroughly Conducted ECG StudiesANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2004Nkechi E. Azie M.D. Background:,The aim of this study was to compare the reproducibility and sensitivity of four commonly used methods for QT interval assessment when applied to ECG data obtained after infusion of ibutilide. Methods:,Four methods were compared: (1) 12-lead simultaneous ECG (12-SIM), (2) lead II ECG (LEAD II), both measured on a digitizing board, (3) 3-LEAD ECG using a manual tangential method, and (4) a computer-based, proprietary algorithm, 12SLÔ ECG Analysis software (AUT). QT intervals were measured in 10 healthy volunteers at multiple time points during 24 hours at baseline and after single intravenous doses of ibutilide 0.25 and 0.5 mg. Changes in QT interval from baseline were calculated and compared across ECG methods, using Bland,Altman plots. Variability was studied using a mixed linear model. Results:,Baseline QT values differed between methods (range 376,395 ms), mainly based on the number of leads incorporated into the measurement, with LEAD II and 3-LEAD providing the shortest intervals. The 3-LEAD generated the largest QT change from baseline, whereas LEAD II and 12-SIM generated essentially identical result within narrow limits of agreement (0.4 ms mean difference, 95% confidence interval ± 20.5 ms). Variability with AUT (standard deviation 15.8 ms for within-subject values) was clearly larger than with 3-LEAD, LEAD II, and 12-SIM (9.6, 10.0, and 11.3 ms). Conclusion:,This study demonstrated significant differences among four commonly used methods for QT interval measurement after pharmacological prolongation of cardiac repolarization. Observed large differences in variability of measurements will have a substantial impact on the sample size required to detect QT prolongation in the range that is currently advised in regulatory guidance. [source] Spatial Properties of QT and the T-Wave MorphologyANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2000Kaspar Lund M.S.S.E. Objective: To describe the relation between the QT interval and the T-wave morphology. Material and methods: Frank orthogonal leads X, Y, Z of one subject and resting 12-lead ECG of 40 subjects. QT was measured by the tangent method. The QT values are organized according to the anatomic orientation of the leads: I, -aVR, II, aVF, III, -aVL, -I, aVR, -II, -aVF, -III, aVL. and: V1, V2, V3, V4, V5, V6, -V1 -V2, -V3, -V4, -V5, -V6. The T-wave amplitudes and QT were categorized according to QT into four groups with increasing mean QT. Results: Kruskal-Wallis nonparametric test showed that the shortest and longest QT values are measured on the T wave with the smallest amplitudes (P < 0.001). Inspection of plots of QT and T waves reveals that the shortest and longest QT values are usually measured in leads with a small difference in orientation (neighbor leads). The mechanism behind these characteristics is mainly that the shortest and longest QT values are measured on T waves that are close to a lead orientation, whereas the T waves are flat or biphasic. We also observed an almost significant (P = 0.057) decrease in the T-wave amplitude with increasing dispersion. Conclusion: The relation between T-wave morphology and QT in the same cardiac plane is highly organized. The shortest and longest QT values are measured on the T wave with the smallest amplitudes (P < 0.001). [source] Lamotrigine does not prolong QTc in a thorough QT/QTc study in healthy subjectsBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 3 2008Ruth Dixon WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT , Drugs that inhibit the human cardiac delayed rectifier potassium current may lead to prolongation of the cardiac QT interval and are associated with a fatal, polymorphic, ventricular tachycardia known as torsades de pointes. , Lamotrigine is indicated in the treatment of epilepsy and the prevention of mood episodes in patients with bipolar disorder. , Lamotrigine inhibits the human cardiac delayed rectifier potassium current in vitro, and it has been hypothesized that QT prolongation may contribute to the risk of sudden unexpected death in epilepsy patients. WHAT THIS STUDY ADDS , This is the first reported thorough QT/QTc study with lamotrigine conducted to International Conference on Harmonization guidelines. , The mean QTc interval was not prolonged by lamotrigine in healthy subjects, as assessed by the standard heart rate correction methods (Fridericia's and Bazett's). , The in vitro inhibition of the delayed rectifier potassium current does not translate into an effect on QT in man. AIM To characterize the effects of lamotrigine on QT interval in healthy subjects. METHODS Healthy subjects received a single oral dose of moxifloxacin (400 mg) or placebo in crossover design, followed by a dose-escalating regimen of lamotrigine (n = 76) over a 77-day period, or matched placebo (n = 76). Blood samples were taken for determination of moxifloxacin and lamotrigine concentrations and digital 12-lead ECGs were recorded. The relationships between individual QT values and respective individual moxifloxacin or lamotrigine concentrations were explored using population pharmacokinetic,pharmacodynamic (PK,PD) modelling. RESULTS Moxifloxacin was associated with a maximum mean increase from baseline in QTcF of 14.81 ms [90% confidence interval (CI) 13.50, 16.11] 2.5 h after dosing. Steady-state exposure to lamotrigine (50, 150 or 200 mg b.d.) was not associated with an increase in QTc interval. Small reductions in QTcF (maximum mean difference from placebo ,7.48 ms, 90% CI ,10.49, ,4.46) and small increases in heart rate (maximum mean difference from placebo 5.94 bpm, 90% CI 3.81, 8.06) were observed with lamotrigine 200 mg b.d. vs. placebo. No effect of lamotrigine on QRS duration or blood pressure was observed. No outliers with QTcF > 450 ms, or with an increase from baseline of >60 ms were observed in the lamotrigine group. PK,PD modelling indicated statistically significant decreases in individually corrected QT intervals for lamotrigine and statistically significant increases in individually corrected QT intervals for moxifloxacin over the concentration ranges studied. CONCLUSIONS Therapeutic doses of lamotrigine (50,200 mg b.d.) were not associated with QT prolongation in healthy subjects. [source] Studies of molecular docking between fibroblast growth factor and heparin using generalized simulated annealingINTERNATIONAL JOURNAL OF QUANTUM CHEMISTRY, Issue 13 2008Samuel Silva da Rocha Pita Abstract Since the middle 70s, the main molecular docking problem consists in limitations to treat adequately the degrees of freedom of protein (or a receptor) due to the energy landscape roughness and the high computational cost. Until recently, only few algorithms considering flexible simultaneously both ligand and receptor at low computational cost were developed. As a recent proposed Statistical Mechanics, generalized simulated annealing (GSA) has been employed at diverse works concerning global optimization problems. In this work, we used this method exploring the molecular docking problem taking into account the FGF-2 and heparin complex. Since the requirements of an efficient docking algorithm are accuracy and velocity, we tested the influence of GSA parameters qA (new configuration acceptance index), qV (energy surface visiting index), and qT (temperature decreasing control) on the performance of GSADOCK program. Our simulations showed that as temperature parameter qT increases, qA parameter follows this behavior in the interval ranging from 1.1 to 2.3. We found that the GSA parameters have the best performance for the qA values ranging from 1.1 to 1.3, qV values from 1.3 to 1.5, and qT values from 1.1 to 1.7. Most of good qV values were equal or next the good qT values. Finally, the implemented algorithm is trustworthy and can be employed as a tool of molecular modeling methods. The final version of the program will be free of charge and will be accessible at our home-page or could be requested to the authors for e-mail. © 2008 Wiley Periodicals, Inc. Int J Quantum Chem, 2008 [source] | ||||||||||