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European Pharmaceutical Contractor
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In recent years, an increasing number of drugs have been withdrawn from the marketplace or have had their labels changed due to their previously undetected capacity to cause potentially fatal arrhythmias associated with the QT interval prolongation. The QT interval on the electrocardiogram (ECG) is the time from the onset of the Q-wave until the ending of the T-wave (typically expressed in milliseconds). It represents the duration of ventricular depolarisation and subsequent repolaristion. In other words, this is a summary of the electrical activities in the ventricular portion of the heart, which are essential prerequisites for the correct functioning and co-ordinated pumping action of the heart muscle.
Due to its inverse relationship to heart rate, the QT interval is routinely transformed into (as far as possible) a heart rate independent value known as the QTc interval (1). The QTc interval is, therefore, a representation of the QT interval at a standardised heart rate (60 bpm) and is calculated by various correction formulae. Bazett's and Fridericia's corrections are the most widely used, although Bazzet's formula is preferred in medical literature, and therefore most criteria for normal and abnormal values are derived from this. However, none of the currently used formulae are perfect and can lead to false conclusions due to over- or under-correction of QT values (2,3).
Although a direct relationship between QT/QTc interval prolongation and drugs arhythmogenecity is still unclear, QT/QTc interval prolongation is the subject of intense scrutiny by both drug regulatory agencies and the pharmaceutical industry.
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