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Submitted: 16 May 2007 Modified: 09 September 2019
HERDIN Record #: PCHRDPC030270

QT dispersion in acute myocardial infarction an electrocardiographic parameter in assessing congestive heart failure.

 Surposa, Emmanuel N,
 Villarosa, Marcelo G

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Recent studies have shown that interlead QT variability on the surface electrocardiogram, defined as QT dispersion, may reflect regional variations in myocardial recovery of excitability. Myocardial Infarction is a relatively common cause of ICU admissions. The aim of this study is to investigate the relationship between a widened QT and/or QTc dispersion and the occurrence of congestive heart failure due to Acute Myocardial Infarction. That is, the more widely dispersed the QT or QTc intervals, the higher the Killip classification of the patients.


METHODS: This is a retrospective study of patients admitted in the ICU of Ospital Ng Makati with a diagnosis of Acute Myocardial Infarction. Data collected included age, sex, location of infarct, presence of arrthythmias, prior co-morbid condition, and outcome. All initial (day 1) 12 L ECGs were analyzed and their QT and QTc dispersion were statistically studied using Analysis of Variance in relation to their Killip classification at that time. Results: Data gathered on age, sex, location of infarct, presence of arrhythmias, prior co-morbid conditions, and outcome were described. QT dispersion of the different Killip classes were significantly different at a p-value of 0.000005. QTc dispersions of the different Killip classes were also significantly different at a p-value of 0.000048.


DISCUSSION/CONCLUSION: The significant QT and QTc dispersion values in relation to the Killip classification reflect the variability of QT and QTc intervals between the different leads, respectively. The increased mortality due to pump failure clinically measured in Killip scores and the associated QT and QTc dispersion may be explained by the dependence of these dispersions on ventricular repolarization and indirectly to ventricular function.


LIMITATIONS/RECOMMENDATION: The small number of patients, the retrospective nature of the study, as well as the selection criteria, do not allow an interpretation of the role of QT and QTc dispersion in prognostication. The measurement of QT and QTc dispersion may give clinicians another parameter to assess venticular function in acute myocardial infarction. In the absence of high-tech ancillary procedures, the measurement of widened QT and QTc dispersions may help us clinicians closely monitor these patients ventricular function especially since these values are associated with the occurence of re-entry arrhythmias

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Internal Medicine
Frequency
Monthly
Publication Date
November-December 1998
Volume
36
Issue
6
Page(s)
209-213
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