Abstract
SummaryObjectiveCarbon monoxide (CO) poisoning leads to cardiac dysrhythmia. Increased heterogeneity in ventricular repolarisation on electrocardiogram (ECG) shows an increased risk of arrhythmia. A number of parameters are used to evaluate ventricular repolarisation heterogeneity on ECG. The aim of our study is to investigate the effect of acute CO poisoning on indirect parameters of ventricular repolarisation on ECG.MethodsSixty-seven patients were included in this case–control study. Thirty patients with acute CO poisoning were assigned to group 1 (19 females, mean age: 30.8 ± 11.3 years). A control group was formed with patients without known cardiac disease (group 2, n = 37; 25 females, mean age: 26.0 ± 5.2 years). Twelve-lead ECG and serum electrolyte levels were recorded in all patients. Also, carboxyhaemoglobin (COHb) levels were recorded in group 1. Tpeak–Tend (TpTe) interval, TpTe dispersion, TpTe/QT ratio, QT interval and QTd durations were measured as parameters of ventricular repolarisation. Corrected QT (QTc) and QTc dispersion (QTcd) intervals were determined with the Bazett’s formula.ResultsThe mean COHb level in group 1 was 27.6 ± 7.4% and mean duration of CO exposure was 163.5 ± 110.9 min. No statistically significant difference was found in age, gender, serum electrolytes or blood pressure levels between the groups. QRS, QT, QTc, TpTe interval and TpTe/QT ratio were similar between the groups (p > 0.05). QTcd (65.7 ± 64.4 vs 42.1 ± 14.2 ms, p = 0.003) and TpTe dispersion (40.5 ± 14.8 vs 33.2 ± 4.9 ms, p = 0.006) were significantly longer in group 1 than group 2. COHb level was moderately correlated with TpTe dispersion (r = 0.29; p = 0.01).ConclusionTo our knowledge, this is the first study to investigate TpTe interval and dispersion in CO poisoning. Our results showed that TpTe dispersion and QTc dispersion increased after CO poisoning.
Highlights
Our results showed that TpTe dispersion and QTc dispersion increased after Carbon monoxide (CO) poisoning
Our results showed that T –T peak end dispersion and QTc dispersion were higher in CO-intoxicated patients compared to normal subjects
Our results indicated that TpTe dispersion may be one of the reasons for arrhythmia caused by CO poisoning
Summary
The ethics committee of Gulhane Military Medical Academy Haydarpasa Teaching Hospital approved the study protocol. Patients who were treated with normobaric oxygen for CO poisoning at the Emergency Department of Gulhane Military Medical Academy between 1 October 2005 and 31 May 2006 comprised the study group. The QT intervals were measured from the onset of the QRS complex to the end of the T wave, defined as the return T-P baseline. The QTc dispersion (QTcd) is the difference between minimum and maximum QTc intervals. TpTe interval was measured from the peak of the T wave to the end of the T wave. The difference between minimum and maximum TpTe intervals on ECG (TpTe.max–TpTe.min) was considered TpTe dispersion. Pearson’s correlation coefficients were determined for the relationship of COHb levels with ECG parameters (QTc, QTcd, TpTe, TpTe dispersion and TpTe/QTc). Statistical analyses were performed using SPSS 11.0 (SPSS Inc., Chicago, IL)
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