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    Nouvel outil rapide, prĂ©cis et facile Ă  enseigner de mesure du QT par concatĂ©nation d’ECG tripliquĂ©s

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    International audienceBackgroundThe gold standard method for assessing the QTcF (QT corrected for heart rate by Fridericia's cube root formula) interval is the “QTcF semiautomated triplicate averaging method” (TAM), which consists of measuring three QTcF values semiautomatically, for each 10-second sequence of a triplicate electrocardiogram set, and averaging them to get a global and unique QTcF value. Thus, TAM is time consuming. We have developed a new method, namely the “QTcF semiautomated triplicate concatenation method” (TCM), which consists of concatenating the three 10-second sequences of the triplicate electrocardiogram set as if they were a single 30-second electrocardiogram, and measuring QTcF only once for the triplicate electrocardiogram set.AimTo compare the TCM method with the TAM method.MethodsFifty triplicate electrocardiograms were read twice by an expert and a student using both methods (TAM and TCM). We plotted Bland–Altman plots to assess agreement between the two methods, and to compare the student and expert results. The time needed to read a set of 20 consecutive triplicate electrocardiograms was measured.ResultsLimits of agreement between TAM and TCM ranged from −8.25 to 6.75 ms with the expert reader. TCM was twice as fast as TAM (17.38 versus 34.28 min for 20 consecutive triplicate electrocardiograms). Bland–Altman plots comparing student and expert results showed limits of agreement ranging from −4.34 to 11.75 ms for TAM, and −1.2 to 8.0 ms for TCM.ConclusionsTAM and TCM show good agreement for QT measurement. TCM is less time consuming than TAM. After a learning session, an inexperienced reader can measure the QT interval accurately with both methods.ContextLa mĂ©thode de rĂ©fĂ©rence de mesure de l’intervalle QT est la « QT/QTcF semi-automated triplicate averaging method » (TAM). Elle consiste Ă  mesurer semi-automatiquement 3 valeurs de QTcF issues de chacun des enregistrements Ă©lectrocardiographiques (ECG) de 10 secondes enregistrĂ©s en triplicata, puis Ă  en faire la moyenne afin d’obtenir une valeur unique de QTcF. Cette mĂ©thode est chronophage. Nous avons dĂ©veloppĂ© une mĂ©thode rĂ©cente –la « QT/QTcF semi-automated triplicate concatenation method » (TCM), consistant en concatĂ©ner les 3 sĂ©quences de 10 secondes de l’ECG acquis en triplicata comme s’il s’agissait d’un seul ECG de 30 secondes, puis Ă  mesurer une seule fois le QTcF.ObjectifNous avons comparĂ© la mĂ©thode TCM Ă  la mĂ©thode TAM.MĂ©thodes50 ECG tripliquĂ©s ont Ă©tĂ© lus par un expert et un Ă©tudiant, en utilisant les 2 mĂ©thodes (TAM et TCM). Une analyse de Bland-Altman a Ă©tĂ© rĂ©alisĂ©e afin d’évaluer la concordance de ces mĂ©thodes, et celles des mesures d’un expert comparĂ© Ă  un Ă©tudiant. Le temps nĂ©cessaire pour mesurer 20 ECG tripliquĂ©s a Ă©tĂ© mesurĂ©.RĂ©sultatsPour l’expert, les limites d’agrĂ©ment Ă  95 % entre TAM et TCM s’étendent de −8,25 Ă  6,75 ms. Entre l’étudiant et l’expert, les limites d’agrĂ©ment sont de −4,34 Ă  11,75 ms avec la TAM, et de −1,2 Ă  8,0 ms avec la TCM. La TCM est deux fois plus rapide que la TAM.ConclusionsLes mĂ©thodes TAM et TCM sont concordantes pour la mesure du QT, la mĂ©thode TCM Ă©tant cependant plus rapide que la mĂ©thode TAM. AprĂšs apprentissage, un Ă©tudiant est capable de mesurer le QT prĂ©cisĂ©ment avec chacune de ces mĂ©thodes
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