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Prolonged QT Interval Corrected for Heart Rate During Diabetic Ketoacidosis in Children: Psychological Stress Could Be Another Explanation—Reply
Nathan Kuppermann, MD, MPH;
Jeanny Park, MD;
Nicole Glaser, MD
Arch Pediatr Adolesc Med. 2009;163(1):93.
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In reply
The letter by Drs Szabo and Andrássy highlights 2 points: (1) mental stress rather than ketosis could account for QTc prolongation during DKA and (2) the Bazett formula can be inaccurate, particularly at elevated heart rates. The reference that Szabo and Andrássy cite regarding the effect of mental stress on QTc appears to be a non–peer-reviewed doctoral thesis.1 Furthermore, in our article,2 we acknowledge the controversy regarding how to best adjust the QT interval for heart rate. We selected the Bazett method, as it is the one most commonly used in practice, despite known intersubject variability in the QT/RR relation.3
Szabo and Andrássy also reference an article published 30 years ago (not 20, as stated) documenting 2 (ie, not "rare") minor arrhythmias in 14 patients (mainly adults) with DKA who underwent continuous ECG monitoring4; QT intervals were . . . [Full Text of this Article] AUTHOR INFORMATION
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RELATED ARTICLE
Prolonged QT Interval Corrected for Heart Rate During Diabetic Ketoacidosis in Children
Nathan Kuppermann, Jeanny Park, Kathryn Glatter, James P. Marcin, and Nicole S. Glaser
Arch Pediatr Adolesc Med. 2008;162(6):544-549.
ABSTRACT
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RELATED LETTER
Prolonged QT Interval Corrected for Heart Rate During Diabetic Ketoacidosis in Children: Psychological Stress Could Be Another Explanation
Attila Szabo and Gábor Andrássy
Arch Pediatr Adolesc Med. 2009;163(1):92-93.
EXTRACT
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