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The Pediatric Forum
January 5, 2009

Prolonged QT Interval Corrected for Heart Rate During Diabetic Ketoacidosis in Children: Psychological Stress Could Be Another Explanation—Reply

Author Affiliations

Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Pediatr Adolesc Med. 2009;163(1):92-93. doi:10.1001/archpediatrics.2008.518

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

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