Association of QRS duration changes during ergonovine provocation test with arrhythmic complications

Abstract

Abstract Background Ergonovine is ergoline-derivatives that act at serotonin-receptors (5-HT2receptor). Influence of serotonin and 5-HT2 receptor agonist on cardiomyocytes has been known. Purpose However, there was limited data about the association between QRS duration changes during ergonovine provocation test (EPT) and arrhythmic complications. Methods A total of 182 patients who underwent coronary angiography (CAG) with EPT were consecutively enrolled (mean age; 53.9±10.4 years, 59.3% male) at our hospital from 2018 to 2019. ECGs recorded closest to the time of CAG were carefully reviewed and measured PR interval, QRS duration, QT and QTc intervals. Results 41 (22.5%) patients had arrhythmic events including atrial, and ventricular tachycarrhythmia during follow-up. The patients with QRS prolongations had higher incidences of arrhythmic events compared with those without QRS changes (P=0.025). In univariate analysis, diabetes mellitus (P=0.05), coronary artery spasm (P=0.031) and QRS prolongations (P=0.036) were significantly associated with arrhythmic events. In multivariate analysis, QRS prolongations [OR 2.496 (1.077–5.784), P=0.033] was independent risk factors for arrhythmic events at the long-term follow-up. ROC curve analysis were performed to define cut-off point for arrhythmic events (QRS prolongation during EPT>10.6 msec [sensitivity = 0.972; specificity = 0.943]; AUC=0.632; P=0.015) Conclusion The patients with QRS duration prolongations during Ergonovine provocation test were associated with higher incidence of arrhythmic events, suggesting more intensive medical therapy with close clinical follow-up will be required. Funding Acknowledgement Type of funding source: None