10 16–23 Of those, only one assessed 1L-ECGs and 12L-ECGs simultaneously, 20 which may have accounted for interval variations in the studies who did not record simultaneously. 15 Only a handful of studies discussed QTI variations. 14 Validation studies in which the usability of QT times was assessed are, however, lacking. 13 Generally, the device has been studied for accurate detection of atrial fibrillation (AF). Of all CE certified and FDA approved devices, the AliveCor heart monitor is among those most extensively validated against 12L-ECGs as reference standard. 10–12 More recently issued 1L-ECGs provide a smartphone-based technique for rhythm and interval registration. They allow immediate ECG recording and require minimal effort by holding a device with two hands for up to 1 min, without the need to undress and attach patches. As such, the recent introduction of handheld single-lead ECG (1L-ECG) devices may present a welcome solution. 9 Logistical challenges may present one hurdle, as not every general practice has the possibility to make a standard 12-lead ECG (12L-ECG) and obtaining 12L-ECGs during home visits can be challenging. 8 However, the compliance of GPs to recommendations for ECG monitoring in patients on QT prolonging drugs is very low. Preferably, general practitioners (GPs) who make ECGs should be able to sufficiently measure and interpret these QTIs. 6 Importantly, practical guidelines on QTI measurements and interpretation are available. Although automated ECG interpretation including QTI measurements are available on most ECG machines, these may not be accurate and specialists prefer manual interpretation. 4 5 Obtaining an ECG to measure and monitor QTIs is therefore clinically relevant. 1–3 QT prolongation increases the likelihood of the malignant ventricular arrhythmia ‘Torsade de Pointes’ and sudden cardiac death, particularly in the presence of risk factors, such as hypokalaemia, use of diuretics, antiarrhythmic drugs or congenital long QT syndromes. Frequently, physicians who carry out consultations will have to prescribe medications that may prolong the QT interval (QTI).
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