Man versus machine? Acquired long QT syndrome in a patient with anorexia nervosa

Abstract

Computer-generated Bazett-corrected QT (QTcB) algorithms are common in clinical practice and can rapidly identify repolarization abnormalities, but accuracy is variable. This report highlights marked rate-corrected QT (QTc) interval prolongation not detected by the computer algorithm. A 26-year-old woman with anorexia nervosa was admitted with severe hypokalemia and ventricular ectopy. Computer-generated QTcB was 485 ms, while manual adjudication yielded a QTcB of 657 ms and a Fridericia-corrected QT (QTcF) interval of 626 ms using digital calipers. Computer-generated QTc intervals may aid in clinical decision-making. However, accuracy is variable, particularly in the setting of ectopy, and requires manual verification.