Comparison of Formulas for Calculation of the Corrected QT Interval in Infants and Young Children

Objective To compare 4 heart rate correction formulas for calculation of the rate corrected QT (QTc) interval among infants and young children. Study design R-R and QT intervals were measured from digital electrocardiograms. QTc were calculated with the Bazett, Fridericia, Hodges, and Framingham formulas. QTc vs R-R graphs were plotted, and slopes of the regression lines compared. Slopes of QTc-R-R regression lines close to zero indicate consistent QT corrections over the range of heart rates. Results We reviewed electrocardiograms from 702 children, with 233 (33%) <1 year of age and 567 (81%) <2 years. The average heart rate was 122 +/- 20 bpm (median 121 bpm). The slopes of the QTc-R-R regression lines for the 4 correction formulas were -0.019 (Bazett); 0.1028 (Fridericia); -0.1241 (Hodges); and 0.2748 (Framingham). With the Bazett formula, a QTc >460 ms was 2 SDs above the mean, compared with prolonged QTc values of 414, 443, and 353 ms for the Fridericia, Hodges, and Framingham formulas, respectively. Conclusions The Bazett formula calculated the most consistent QTc; 460 ms is the best threshold for prolonged QTc. The study supports continued use of the Bazett formula for infants and children and differs from the use of the Fridericia correction during clinical trials of new medications.