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Application of the Bogossian formula for evaluation of the QT interval in pacemaker patients with stimulated left bundle branch block

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Abstract

Background

The presence of left bundle branch block (LBBB) represents a particular challenge in properly measuring the QT interval. Here we demonstrate the applicability of the “Bogossian formula” in pacemaker patients with LBBB due to apical or nonapical right ventricular (RV) pacing and preserved left ventricular function.

Methods

A total of 163 patients with a cardiac one- or two-chamber pacemaker were included in this prospective, multicentre observational study. Twelve-lead ECG recordings were obtained during both intrinsic rhythm and RV pacing with induced LBBB. The QT interval measured during LBBB was corrected using the Bogossian formula to obtain the “modified QT” (QTm). The QTmc interval was calculated with the Bazett formula, and this was compared with the QTc interval during intrinsic rhythm.

Results

Eighty-three patients (78 ± 9 years; male n = 83) with apical and eighty patients (71 ± 13 years; male n = 80) with non-apical RV pacing were included in this study. In the apical group the QTmc was determined to be 444 ± 39 ms in paced rhythm and the QTc interval 413 ± 36 ms in intrinsic rhythm. In the non-apical group these values were 430 ± 34 ms in paced and 416 ± 32 ms in intrinsic rhythm.

Conclusion

The Bogossian formula is a reliable tool for QTc interval evaluation in pacemaker patients with LBBB due to apical or non-apical RV pacing. However, an overestimation of 30 ms should be included in the calculation.

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Acknowledgements

We thank Inga Bayh and Prof. Dr. Frank Krummenauer (Institute for Medical Biometry and Epidemiology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany) for statistical advice.

Author information

Author notes

  1. K. F. Weipert and H. Bogossian contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology and Angiology, Medical Clinic I, University Clinic of Gießen, Gießen, Germany

    K. F. Weipert, P. Conzen, C. Gemein, I. Helmig, R. Chasan, C. W. Hamm, J. Schmitt & D. Erkapic

  2. Department of Cardiology and Angiology, Märkische Kliniken GmbH, Klinikum Lüdenscheid, Lüdenscheid, Germany

    H. Bogossian, B. Lemke & M. Zarse

  3. Department of Cardiology, University Witten/Herdecke, Witten, Germany

    H. Bogossian, M. Seyfarth & M. Zarse

  4. Division of Electrophysiology, Department of Cardiovascular Medicine, University of Münster, Münster, Germany

    G. Frommeyer & L. Eckardt

  5. Department of Cardiology, Helios Klinikum Wuppertal, Wuppertal, Germany

    M. Seyfarth

  6. Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany

    C. W. Hamm

  7. Department of Cardiology, Diakonie Jung-Stilling Hospital, Wichernstrasse 40, 57074, Siegen, Germany

    D. Erkapic

Authors
  1. K. F. Weipert
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  2. H. Bogossian
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  3. P. Conzen
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  4. G. Frommeyer
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  5. C. Gemein
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  6. I. Helmig
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  7. R. Chasan
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  8. L. Eckardt
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  9. M. Seyfarth
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  10. B. Lemke
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  11. M. Zarse
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  12. C. W. Hamm
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  13. J. Schmitt
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  14. D. Erkapic
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Corresponding author

Correspondence to D. Erkapic.

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Weipert, K.F., Bogossian, H., Conzen, P. et al. Application of the Bogossian formula for evaluation of the QT interval in pacemaker patients with stimulated left bundle branch block. Clin Res Cardiol 107, 1033–1039 (2018). https://doi.org/10.1007/s00392-018-1275-6

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  • DOI: https://doi.org/10.1007/s00392-018-1275-6

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