USE OF ELECTROCARDIOGRAPHIC MARKERS TO PREDICT VENTRICULAR ARRHYTHMIAS IN ACUTE MYOCARDITIS PATIENTS

Year 2017, Issue: 1, 6 - 10, 01.02.2017

Öznur Yumurtacı Cansu Kurt Fatih Mehmet Uçar Cihan Öztürk

Abstract

Aims: Acute myocarditis is an inflammatory disease of the myocardium and is characterized by a large heterogeneity
of clinical presentation. Myocarditis is becoming to be recognized as a contributor to unexplained mortality, and
is thought to be a major cause of sudden cardiac death in the first two decades of life. Myocardial inflammation, ion
channel dysfunction, electrophysiological and structural remodelling may play important roles in life-threatening
arrhythmias. We aimed to investigate the ventricular arrhythmia predictors in myocarditis patients by using electrocardiographic
markers.
Methods: A total of 56 patients (mean age 22.5 ± 3.7 years; 89% males) with acute myocarditis were enrolled in
the study. Tpeak-Tend intervals, Tpeak-Tend/QT and Tpeak-Tend/corrected QT (QTc), cardio-electrophysiological
balance (QT/QRS) and heart rate-corrected QT(QTc)/QRS ratios were calculated from 12-lead electrocardiogram.
Results: Heart rate, QT and QTc values were similar between groups. QRS complexes were lower in arrhythmia
positive group than arrhythmia negative group (p=0.004). Tpeak-Tend intervals, Tpeak-Tend/QT, Tpeak-Tend/ QTc,
cardio-electrophysiological balance and heart rate-corrected QT(QTc)/QRS values were significantly higher in arrhythmia
positive group (< 0.001, < 0.001, p=0.03, p=0.04 and < 0.001, respectively).
Conclusion: In this study, we observed that higher Tpeak-Tend, Tpeak-Tend/QT, Tpeak-Tend/QTc , cardio-electrophysiological
balance (ICEB) and heart rate-corrected QT(QTc)/QRS ratio are associated with ventricular
arrhythmic episodes in acute myocarditis patients. These electrocardiographic markers may be beneficial to identify
high risk patients for arrhytmias complicating myocarditis.

Keywords

Arrhythmia, electrocardiography, myocarditis