221 Impact of Liver Transplantation on QT Interval in Patients With Cirrhosis

Abstract

Prolongation of the corrected QT-interval (QTc) is the electrophysiological hallmark of cirrhotic cardiomyopathy. However, it is unclear whether liver transplantation (LT) and associated reversal of the cirrhotic milieu affects QTc. We sought to examine whether liver transplantation had any effect on a patient’s corrected QT-interval. Consecutive adult inpatients undergoing LT between 2010-2017 at a state-wide liver transplant centre in Melbourne, Australia were included in this study. The preoperative, immediate postoperative (day 1 post-LT) and follow-up (median 6 months post-LT) QT-intervals were manually measured by a cardiologist blinded to the clinical outcomes. QTc was calculated using the Bazett formula (QT interval/√RR interval). A QTc ≥440msec in either sex was considered prolonged in liver cirrhosis. Overall, 600 ECGs among 300 patients (mean age 57±10 years) undergoing LT were assessed. 171 (57%) patients pre-LT had a QTc ≥440msec and 16 (5.2%) patients had a QTc ≥500msec. ECG at long-term follow-up (median 6 months), revealed significant reduction in QTc (451±30±429±30msec; p<0.001). Following LT, only 62 (20.6%) of patients had QTc ≥440msec. Over half of patients undergoing LT had a prolonged QT interval. LT led to normalisation of QTc in the majority of individuals within 6 months. This suggests that LT can lead to a reversal of the underlying electrophysiological substrate that characterises cirrhotic cardiomyopathy.