QT Dispersion in Acute Coronary Syndrome and Its Significance in Predicting Life-threatening Arrhythmias
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 7
Abstract
Introduction: QT interval prolongation is known to occur in Acute Myocardial Infarction and it is known that temporary QT prolongation during Acute Myocardial Infarction predicts ventricular tachyarrhythmia. Purpose: To assess whether increased QT dispersion (QTd) in Acute Myocardial Infarction predicts the development of ventricular arrhythmias and effects of thrombolysis on QTd with its relation to inhospital mortality. This study aims to measure the QT dispersion in patients with acute myocardial infarction. Material and Methods: Sixty Patients of STEMI in ECG and meet the inclusion and exclusion criterias were included. Both the QTd apex and QTd end was calculated and corrected QTd (QTcd) was obtained using Bazett's formula. This study was designed as a case control study and cases were further divided as (i) thrombolyzed and nonthrombolyzed group and (ii) VES, VT and VF group and nonarrhythmic groups. This study aims to measure the QT dispersion in patients with acute myocardial infarction. Results: Out of total 60 cases, The mean QTd among the AWMI was significantly higher with this cut off (p<0.001) and In this study the mean QTd of 79.14% of cases was observed to be above this cut off value. All indices of QTd dispersion on admission in IWMI cases were significantly higher when compared to control group (p<0.0001). An arbitrary cut of value for all QTd indices, which predicts occurrence of IWMI was considered>50mm/sec and In this study mean QTd of 69.23% of cases was observed to be above this cut off value. Thrombolysed group showed significant reduction in all QTd indices after 72 hrs as compared with their respective observation on admission (p<0.01). As compared to 44.1% of AWMI Cases only 19.2% of IWMI cases developed arrhythmia's (VES, VT, VF) during the course of study. Overall 25% of the total cases developed arrhythmias. All indices of QTd were significantly higher among the arrhythmic groups. All QTd indices were significantly increased in arrhythmic group when compared to non-arrhythmic group (p<0.0001). Conclusion: QT dispersion in acute STEMI cases was found to be significantly higher in comparison with normal subjects. QTd was significantly higher in patients with AWMI and in cases who developed ventricular arrhythmias than patients with IWMI and with non-arrhythmic group. In STEMI case thrombolysis significantly decreased the QTd and the risk to ventricular tachyarrhythmias.
Authors and Affiliations
Mohd Suhel Siddiqui, Sandeep Singh, Manoj Malav, Tarunendra Mishra
Keywords
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