ECG Changes in Patients with Amitriptyline Intoxication; P, QT, QTC, T and PR Wave Dispersion: A Retrospective Study

Abstract

Objective: Amitriptyline intoxication is a life-threatening condition as it can cause cardiac arrhythmias. This study aims to examine the ECG changes in patients with amitriptyline intoxications who were admitted to the emergency department and to compare the P-wave, T-wave, QT, QTC, and PR dispersions with healthy controls.
 Material and Methods: The sample of the current retrospective study consists of only 46 patients with amitriptyline intoxication and 65 healthy controls. The 12-channel ECG recordings of the participants were evaluated by two experienced cardiologists. P wave, T wave, QT, QTC, and PR distance, minimum, maximum, and dispersion values were measured. The obtained data were recorded on the data set and subjected to statistical analysis.
 Results: There was no significant difference in sociodemographic variables between patients with amitriptyline intoxication and the control group. The main symptoms of the patients were as follows: 28.3% (n=13) lethargy, 32.6% (n=15) nausea-vomiting, 21.7% (n=10) unconsciousness, and 17.4% (n=8) other. According to the analysis of amitriptyline intoxication and ECG parameters of healthy controls, P-wave, T-wave, QT, QTC, and PR dispersion were higher in the intoxication group than in the healthy controls (p0.05). The patient group had a higher heart rate than the control group (p=0.026).
 Conclusion: The current study found that P-wave, T-wave, QT, QTC, and PR dispersion were higher in the amitriptyline intoxication group than in the control group, which is thought to play a role in cardiac arrhythmias. Clinicians should be on alert for any ECG changes in these cases.