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The rule of thumb is less accurate, and the risk is higher because a long QT in the presence of bradycardia ("pause dependent" Torsades) predisposes to Torsades. 6) Use a different rule of thumb for bradycardia : Manually approximate both the QT and the RR interval. 3) At heart rates below 60, far more caution is due.
Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. Abnormal ECG – looks for cardiac syncope.
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