Document Detail

Comparison of QTinno, a fully automated electrocardiographic analysis program, to semiautomated electrocardiographic analysis methods in a drug safety study in healthy subjects.
MedLine Citation:
PMID:  19362316     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Improved automated methods for electrocardiographic (ECG) analysis are needed, particularly for drug development purposes. OBJECTIVES: This study compared a novel fully automated method for ECG analysis (QTinno; NewCardio, Santa Clara, CA) to 2 semiautomated digital methods: global measurement from the earliest QRS onset to the latest T-wave offset on representative superimposed beats (global) and tangent measurement on 3 consecutive beats in one lead (tangent). METHODS: All 3 methods were used to determine uncorrected and rate-corrected QT interval duration (QT and QTcF) and related metrics in 1422 digital 12-lead ECGs from a phase 1 drug study. Global and tangent annotations were manually adjusted by the same 3 cardiologists wherever necessary. No adjustments were made in QTinno determinations. RESULTS: QTinno returned QTcF change from time-matched baseline (DeltaQTcF) that differed minimally from both global and tangent methods (mean pairwise difference: 0.1 millisecond between QTinno and global, 1.1 milliseconds between QTinno and tangent). The average absolute QT and QTcF intervals by QTinno were approximately 5 milliseconds longer than global and 25 milliseconds longer than by tangent. QTinno had lower intrinsic variability for DeltaQTcF than either global or tangent (between-subject SD: QTinno 4.0 milliseconds, global 5.6 milliseconds, tangent 6.4 milliseconds; within-subject SD: QTinno 4.8 milliseconds, global 7.4 milliseconds, tangent 10.6 milliseconds). All methods were robust in detecting the largest placebo-adjusted mean time-matched DeltaQTcF (15-25 milliseconds) induced by study drug. CONCLUSIONS: The methods show good agreement for drug-induced QTc prolongation. Lower intrinsic variability of DeltaQTcF by QTinno could facilitate smaller sample sizes or increase study power in thorough QTc studies.
Nenad Sarapa; Ihor Gussak; Branislav Vajdic; Samuel George; Ljupco Hadzievski; Steven F Francom; Peter Kowey
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-04-10
Journal Detail:
Title:  Journal of electrocardiology     Volume:  42     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-09-03     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  358-66     Citation Subset:  IM    
Johnson & Johnson PRD, Spring House, PA, USA.
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MeSH Terms
Diagnosis, Computer-Assisted / methods*
Drug Evaluation / methods*
Drug Toxicity
Electrocardiography / methods*
Reference Values
Reproducibility of Results
Sensitivity and Specificity

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