The correlation between serum ionized calcium (Ca++) levels and three ECG QT intervals (Q-O TC, Q-A Tc, and Q-E TC) was assessed in 20 adult patients. The relationship between each QT interval and Ca++ level, based on 209 Ca++ determinations through a range of 1.0 to 4.0 mEq/liter, is best described by a hyperbolic function. Although Q-O TC and Q-A TC predict Ca++ levels more accurately than Q-E TC, all QT intervals are clinically unreliable as guides to the presence of hypercalcemia. Similarly, the usefulness of the QT intervals in the diagnosis of hypocalcemia is limited by the wide distribution of normal values.
(JAMA 240:366-368, 1978)