Features of an exceptionally narrow QRS data set

Rory Childers, Anthony Holmes, Masha Kocherginsky, Daniel Childers, Joseph J Pariser

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Little attention has been directed to the characteristics of electrocardiograms (ECGs) with brief QRS durations (BD). Methods: From a database of 859 977 computer-analyzed (Marquette 12SL, GE Healthcare, Milwaukee, WI, USA) ECGs of 216 148 patients, 1805 patients (data set of BD: 19 718 ECGs; age, >18 years, unpaced), had, in at least one ECG, a QRS duration of less than 62 milliseconds, a prevalence of 0.8%. Results: The QRS duration ranged from 46 to 188 milliseconds; values fluctuated between excessive brevity and the traditionally normal (80-95 milliseconds), with many values in the 60's. The average age at first acquisition was 56 years (range, 18-96 years); 1371 were female (76%) and 433 were males (24%); and 416 were white (23%), 1243 African American (69%), 109 other (6%). The summed 12-lead QRS amplitude (ΣQRS) ranged from 2800 to 32 929 μV (mean ± SD, 11 154 ± 4101), and heart rate ranged from 40 to 269 (98 ± 26). There was a statistically positive relationship between QRS duration (in the range 52-105 milliseconds) and ΣQRS (P < 0001): for each 1000 μV increment, duration increased by 0.7 milliseconds (95% confidence interval [CI], 0.66-0.73 milliseconds). Conversely, for each 5-millisecond increment in duration, ΣQRS increased by 475 μV (95% CI, 450-498 μV). There was an inverse relationship between QRS duration and heart rate (P < .0001): for every 10 beat rate increase, the duration dropped by 1.14 milliseconds (95% CI, 1.09-1.19 milliseconds). An additional data set of normal QRS durations ND consisted of 2902 subjects, none of whose 40 327 ECGs showed a QRS duration less than 62 milliseconds; 2.8% of ND ECGs had durations in the 62-69 millisecond range, 26% in BD. Sinus tachycardia was 43% in BD and 24% in ND. The average age of ND was 58 years (range, 18-100 years); 44% were male and 56% female; and 39% were white and 57% were African American. A positive relationship between duration and amplitude was found among ND subjects as well: for each 1000 point increase in ΣQRS, duration increased by 0.45 milliseconds (P < .0001; 95% CI, 0.42-0.47 milliseconds). The duration amplitude relationship did not hold for durations greater than 105 milliseconds in either data set. Conclusion: Over the full extended span of QRS durations (46-106 milliseconds), the value of the latter is directly related to the total summed amplitude of the 12-lead QRS. An inverse relationship is demonstrable with heart rate.

Original languageEnglish (US)
Pages (from-to)501-507
Number of pages7
JournalJournal of Electrocardiology
Volume41
Issue number6
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

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Electrocardiography
Confidence Intervals
Heart Rate
African Americans
Sinus Tachycardia
Datasets
Databases
Delivery of Health Care
Lead

Keywords

  • Dynamic relationship between basic electrocardiographic measurements
  • Heart rate and QRS duration
  • Voltage and QRS duration

Cite this

Features of an exceptionally narrow QRS data set. / Childers, Rory; Holmes, Anthony; Kocherginsky, Masha; Childers, Daniel; Pariser, Joseph J.

In: Journal of Electrocardiology, Vol. 41, No. 6, 01.11.2008, p. 501-507.

Research output: Contribution to journalArticle

Childers, R, Holmes, A, Kocherginsky, M, Childers, D & Pariser, JJ 2008, 'Features of an exceptionally narrow QRS data set', Journal of Electrocardiology, vol. 41, no. 6, pp. 501-507. https://doi.org/10.1016/j.jelectrocard.2008.06.014
Childers, Rory ; Holmes, Anthony ; Kocherginsky, Masha ; Childers, Daniel ; Pariser, Joseph J. / Features of an exceptionally narrow QRS data set. In: Journal of Electrocardiology. 2008 ; Vol. 41, No. 6. pp. 501-507.
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abstract = "Background: Little attention has been directed to the characteristics of electrocardiograms (ECGs) with brief QRS durations (BD). Methods: From a database of 859 977 computer-analyzed (Marquette 12SL, GE Healthcare, Milwaukee, WI, USA) ECGs of 216 148 patients, 1805 patients (data set of BD: 19 718 ECGs; age, >18 years, unpaced), had, in at least one ECG, a QRS duration of less than 62 milliseconds, a prevalence of 0.8{\%}. Results: The QRS duration ranged from 46 to 188 milliseconds; values fluctuated between excessive brevity and the traditionally normal (80-95 milliseconds), with many values in the 60's. The average age at first acquisition was 56 years (range, 18-96 years); 1371 were female (76{\%}) and 433 were males (24{\%}); and 416 were white (23{\%}), 1243 African American (69{\%}), 109 other (6{\%}). The summed 12-lead QRS amplitude (ΣQRS) ranged from 2800 to 32 929 μV (mean ± SD, 11 154 ± 4101), and heart rate ranged from 40 to 269 (98 ± 26). There was a statistically positive relationship between QRS duration (in the range 52-105 milliseconds) and ΣQRS (P < 0001): for each 1000 μV increment, duration increased by 0.7 milliseconds (95{\%} confidence interval [CI], 0.66-0.73 milliseconds). Conversely, for each 5-millisecond increment in duration, ΣQRS increased by 475 μV (95{\%} CI, 450-498 μV). There was an inverse relationship between QRS duration and heart rate (P < .0001): for every 10 beat rate increase, the duration dropped by 1.14 milliseconds (95{\%} CI, 1.09-1.19 milliseconds). An additional data set of normal QRS durations ND consisted of 2902 subjects, none of whose 40 327 ECGs showed a QRS duration less than 62 milliseconds; 2.8{\%} of ND ECGs had durations in the 62-69 millisecond range, 26{\%} in BD. Sinus tachycardia was 43{\%} in BD and 24{\%} in ND. The average age of ND was 58 years (range, 18-100 years); 44{\%} were male and 56{\%} female; and 39{\%} were white and 57{\%} were African American. A positive relationship between duration and amplitude was found among ND subjects as well: for each 1000 point increase in ΣQRS, duration increased by 0.45 milliseconds (P < .0001; 95{\%} CI, 0.42-0.47 milliseconds). The duration amplitude relationship did not hold for durations greater than 105 milliseconds in either data set. Conclusion: Over the full extended span of QRS durations (46-106 milliseconds), the value of the latter is directly related to the total summed amplitude of the 12-lead QRS. An inverse relationship is demonstrable with heart rate.",
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AU - Childers, Rory

AU - Holmes, Anthony

AU - Kocherginsky, Masha

AU - Childers, Daniel

AU - Pariser, Joseph J

PY - 2008/11/1

Y1 - 2008/11/1

N2 - Background: Little attention has been directed to the characteristics of electrocardiograms (ECGs) with brief QRS durations (BD). Methods: From a database of 859 977 computer-analyzed (Marquette 12SL, GE Healthcare, Milwaukee, WI, USA) ECGs of 216 148 patients, 1805 patients (data set of BD: 19 718 ECGs; age, >18 years, unpaced), had, in at least one ECG, a QRS duration of less than 62 milliseconds, a prevalence of 0.8%. Results: The QRS duration ranged from 46 to 188 milliseconds; values fluctuated between excessive brevity and the traditionally normal (80-95 milliseconds), with many values in the 60's. The average age at first acquisition was 56 years (range, 18-96 years); 1371 were female (76%) and 433 were males (24%); and 416 were white (23%), 1243 African American (69%), 109 other (6%). The summed 12-lead QRS amplitude (ΣQRS) ranged from 2800 to 32 929 μV (mean ± SD, 11 154 ± 4101), and heart rate ranged from 40 to 269 (98 ± 26). There was a statistically positive relationship between QRS duration (in the range 52-105 milliseconds) and ΣQRS (P < 0001): for each 1000 μV increment, duration increased by 0.7 milliseconds (95% confidence interval [CI], 0.66-0.73 milliseconds). Conversely, for each 5-millisecond increment in duration, ΣQRS increased by 475 μV (95% CI, 450-498 μV). There was an inverse relationship between QRS duration and heart rate (P < .0001): for every 10 beat rate increase, the duration dropped by 1.14 milliseconds (95% CI, 1.09-1.19 milliseconds). An additional data set of normal QRS durations ND consisted of 2902 subjects, none of whose 40 327 ECGs showed a QRS duration less than 62 milliseconds; 2.8% of ND ECGs had durations in the 62-69 millisecond range, 26% in BD. Sinus tachycardia was 43% in BD and 24% in ND. The average age of ND was 58 years (range, 18-100 years); 44% were male and 56% female; and 39% were white and 57% were African American. A positive relationship between duration and amplitude was found among ND subjects as well: for each 1000 point increase in ΣQRS, duration increased by 0.45 milliseconds (P < .0001; 95% CI, 0.42-0.47 milliseconds). The duration amplitude relationship did not hold for durations greater than 105 milliseconds in either data set. Conclusion: Over the full extended span of QRS durations (46-106 milliseconds), the value of the latter is directly related to the total summed amplitude of the 12-lead QRS. An inverse relationship is demonstrable with heart rate.

AB - Background: Little attention has been directed to the characteristics of electrocardiograms (ECGs) with brief QRS durations (BD). Methods: From a database of 859 977 computer-analyzed (Marquette 12SL, GE Healthcare, Milwaukee, WI, USA) ECGs of 216 148 patients, 1805 patients (data set of BD: 19 718 ECGs; age, >18 years, unpaced), had, in at least one ECG, a QRS duration of less than 62 milliseconds, a prevalence of 0.8%. Results: The QRS duration ranged from 46 to 188 milliseconds; values fluctuated between excessive brevity and the traditionally normal (80-95 milliseconds), with many values in the 60's. The average age at first acquisition was 56 years (range, 18-96 years); 1371 were female (76%) and 433 were males (24%); and 416 were white (23%), 1243 African American (69%), 109 other (6%). The summed 12-lead QRS amplitude (ΣQRS) ranged from 2800 to 32 929 μV (mean ± SD, 11 154 ± 4101), and heart rate ranged from 40 to 269 (98 ± 26). There was a statistically positive relationship between QRS duration (in the range 52-105 milliseconds) and ΣQRS (P < 0001): for each 1000 μV increment, duration increased by 0.7 milliseconds (95% confidence interval [CI], 0.66-0.73 milliseconds). Conversely, for each 5-millisecond increment in duration, ΣQRS increased by 475 μV (95% CI, 450-498 μV). There was an inverse relationship between QRS duration and heart rate (P < .0001): for every 10 beat rate increase, the duration dropped by 1.14 milliseconds (95% CI, 1.09-1.19 milliseconds). An additional data set of normal QRS durations ND consisted of 2902 subjects, none of whose 40 327 ECGs showed a QRS duration less than 62 milliseconds; 2.8% of ND ECGs had durations in the 62-69 millisecond range, 26% in BD. Sinus tachycardia was 43% in BD and 24% in ND. The average age of ND was 58 years (range, 18-100 years); 44% were male and 56% female; and 39% were white and 57% were African American. A positive relationship between duration and amplitude was found among ND subjects as well: for each 1000 point increase in ΣQRS, duration increased by 0.45 milliseconds (P < .0001; 95% CI, 0.42-0.47 milliseconds). The duration amplitude relationship did not hold for durations greater than 105 milliseconds in either data set. Conclusion: Over the full extended span of QRS durations (46-106 milliseconds), the value of the latter is directly related to the total summed amplitude of the 12-lead QRS. An inverse relationship is demonstrable with heart rate.

KW - Dynamic relationship between basic electrocardiographic measurements

KW - Heart rate and QRS duration

KW - Voltage and QRS duration

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