Conduction: Difference between revisions

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Although QT prolongation is potentially lethal, measurement of the QT interval by physicians is poor as different definitions of the end of the T wave exist.<cite>Viskin</cite> Most QT experts define the end of the T wave as the intersection of the steepest tangent line from the end of the T-wave with the base line of the ECG.<cite>Lepeschkin</cite> This leads to the following stepwise approach:
Although QT prolongation is potentially lethal, measurement of the QT interval by physicians is poor as different definitions of the end of the T wave exist.<cite>Viskin</cite> Most QT experts define the end of the T wave as the intersection of the steepest tangent line from the end of the T-wave with the base line of the ECG.<cite>Lepeschkin</cite> This leads to the following stepwise approach:


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!Stepwise approach to correct measurement of the QT interval
!Stepwise approach to correct measurement of the QT interval
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In  a (serious) prolonged QT time, it takes longer for the myocardial cells to be ready for a new cardiac cycle. There is a possibility that some cells are not yet repolarized, but that a new cardiac cycle is already initiated. These cells are at risk for uncontrolled depolarization and induce [[Torsade de Pointes]] and subsequent [[Ventricular Fibrillation]].
In  a (serious) prolonged QT time, it takes longer for the myocardial cells to be ready for a new cardiac cycle. There is a possibility that some cells are not yet repolarized, but that a new cardiac cycle is already initiated. These cells are at risk for uncontrolled depolarization and induce [[Torsade de Pointes]] and subsequent [[Ventricular Fibrillation]].


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! Causes of QT prolongation
! Causes of QT prolongation
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If the QT segment is abnormal, it can be difficult to define the end of the T wave. Below are a number of examples that suggest how QT should be measured in these patients.
If the QT segment is abnormal, it can be difficult to define the end of the T wave. Below are a number of examples that suggest how QT should be measured in these patients.
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!colspan='3'|How to measure QT if the QT segement is abnormal
!colspan='3'|How to measure QT if the QT segement is abnormal
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