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Measurement of high resolution ECG QT interval during controlled euglycaemia and hypoglycaemia

R H Ireland1, R T C E Robinson2, S R Heller2, J L B Marques3 and N D Harris1

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During hypoglycaemia, typically there is a change in the surface ECG characterized by a flattened and prolonged T wave, often accompanied by a fused U wave. The QT interval is a useful parameter for quantifying the ECG morphology. However, reliable measurement of QT is not straightforward, particularly for hypoglycaemic ECG morphology. The objective of this study was to compare the ability of two methods of QT measurement to distinguish between ECGs recorded during euglycaemia and hypoglycaemia. The first method involves manually setting the intersection of the isoelectric line and the T wave or, where this is not possible, the nadir between the T and U wave. The second method is semi-automatic and fits a tangent to the point of maximum gradient on the downward slope of the T wave. Two independent observers used both methods to measure the QT for high resolution ECG data recorded during a study of 17 non-diabetic subjects undergoing controlled euglycaemia and hypoglycaemia. Using the mean results of the two observers, the mean±SD increase in heart rate corrected QT, QTc, for ECGs recorded during euglycaemia and hypoglycaemia was 32±25 ms for the non-tangent method and 60±24 ms for the tangent method. Therefore, the tangent method provides greater distinction between ECGs recorded during euglycaemia and hypoglycaemia than the non-tangent method. A potential clinical application could be the non-invasive detection of impending hypoglycaemia at night, which would be of significant benefit to adults and young children with diabetes.


PACS

87.80.-y Biophysical techniques (research methods)

87.19.X- Diseases

87.19.Hh Cardiac dynamics

87.19.R- Mechanical and electrical properties of tissues and organs

Subjects

Instrumentation and measurement

Medical physics

Biological physics

Dates

Issue 2 (May 2000)

Received 7 October 1999, in final form 27 January 2000



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