title: Comparison of QT Interval Readings in Normal Sinus Rhythm Between a Smartphone Heart Monitor and a 12-Lead ECG for Healthy Volunteers and Inpatients Receiving Sotalol or Dofetilide.
abstract: A variety of medications ranging from antiarrhythmics to psychotropics, as well as conditions such as bradycardia, can prolong the QT interval, increasing the risk for life-threatening arrhythmias. Monitoring the corrected QT interval (QTc) is therefore critical for patient safety. The recent development of smart phone heart monitors (SHM) may allow for easier QTc monitoring. We sought to evaluate the accuracy of an SHM for assessing the QTc, as compared to the standard 12-lead ECG.
  
  
  
  We compared the QTc interval in lead-I and lead-II between an SHM and 12-lead ECG. Healthy volunteers and hospitalized patients in sinus rhythm being loaded on dofetilide or sotalol were included. Manual and automatic measurements were studied. Across 99 healthy volunteers, the SHM QTc demonstrated good agreement (bias = 4 milliseconds, standard deviation of bias = 11 milliseconds) compared to the 12-lead ECG, using the Bland-Altman method of agreement. Across all hospitalized patients, the SHM was capable of demonstrating QTc prolongation. Between the 12-lead ECG and SHM, lead-I measurements had reasonable agreement (bias = 3 milliseconds, standard deviation of bias = 46 milliseconds). A QTc of > 500 milliseconds was associated with a higher likelihood (OR = 12.0; 95% CI 1.5-111.4; P = 0.02) to not achieve perfect agreement.
  
  
  
  The SHM is accurate in measuring QTc interval in sinus rhythm when compared to 12-lead ECG in healthy volunteers. For patients receiving QT prolonging antiarrhythmics, SHM is capable of detecting QTc prolongation, and lead-I of the SHM is most accurate in measuring the QTc if < 500 milliseconds.
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Garabelli
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Stavros
authors.initials: S
authors.lastname: Stavrakis
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Albert
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Koomson
authors.forename: Purvi
authors.initials: P
authors.lastname: Parwani
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Jawad
authors.initials: J
authors.lastname: Chohan
authors.affiliation: AliveCor, Oklahoma City, Oklahoma, USA.
authors.forename: Landgrave
authors.initials: L
authors.lastname: Smith
authors.affiliation: AliveCor, Oklahoma City, Oklahoma, USA.
authors.forename: David
authors.initials: D
authors.lastname: Albert
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Rongsheng
authors.initials: R
authors.lastname: Xie
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Qiying
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Dwight
authors.initials: D
authors.lastname: Reynolds
authors.affiliation: Section of Cardiovascular Diseases and Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
authors.forename: Sunny
authors.initials: S
authors.lastname: Po
mesh_terms: D000200:Action Potentials / Q000187:drug effects; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D016022:Case-Control Studies; D004562:Electrocardiography / Q000295:instrumentation*; D005260:Female; D064368:Healthy Volunteers; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D010627:Phenethylamines / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D000068997:Smartphone; D013015:Sotalol / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D000889:Anti-Arrhythmia Agents; D010627:Phenethylamines; D013449:Sulfonamides; D013015:Sotalol; C063533:dofetilide
keywords: QTc; dofetilide QT; sotalol