Marios Kolios1, Tong Liu2, Antonios P Vlahos3, Eleni Kapsali4, Panagiotis Korantzopoulos1. 1. First Department of Cardiology, Faculty of Medicine, University of Ioannina Ioannina, Greece. 2. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University Tianjin, China. 3. Department of Pediatric Cardiology, Faculty of Medicine, University of Ioannina Ioannina, Greece. 4. Department of Hematology, Faculty of Medicine, University of Ioannina Ioannina, Greece.
Abstract
OBJECTIVE: Adult beta-thalassemia major (TM) patients exhibit electrocardiographic abnormalities and cardiac autonomic dysfunction. We aimed to investigate the evolution of electrocardiographic abnormalities and arrhythmias in TM patients during a 12-month follow-up period. METHODS: Forty-seven adult TM patients (median age: 36 years, 57% men) without overt heart failure were studied. We examined 12-lead electrocardiograms, 24-hour electrocardiographic Holter recordings, and treadmill exercise stress tests at baseline and after 12 months. Conventional electrocardiographic measurements, as well as contemporary indexes of depolarization and repolarization/dispersion of repolarization (QRS fragmentation; T peak-to-end; T peak-to-end/QT) were assessed. Moreover, we examined markers of autonomic dysfunction such as heart rate variability, and heart rate recovery after exercise testing. RESULTS: The electrocardiographic markers of atrial/ventricular depolarization and repolarization, as well as indexes of autonomic imbalance, were not significantly changed. However, the recorded supraventricular ectopic beats increased significantly. Paroxysmal atrial fibrillation (PAF) detection was greater in 12 months (4/47 at baseline vs. 8/47 at 12 months; P=0.38). However, 5/8 patients who were diagnosed with PAF at the second examination did not have the arrhythmia at the initial evaluation. Thus, PAF was present in a total of 9/47 (19%) TM patients. Notably, 3/9 of the patients were asymptomatic. The mean duration of PAF was 5±2 minutes and the mean number of these episodes was 8±2. CONCLUSION: TM patients have repolarization and autonomic function abnormalities that do not significantly change during a 12-month follow-up period. However, supraventricular ectopy and AF burden further evolve. AJCD
OBJECTIVE: Adult beta-thalassemia major (TM) patients exhibit electrocardiographic abnormalities and cardiac autonomic dysfunction. We aimed to investigate the evolution of electrocardiographic abnormalities and arrhythmias in TM patients during a 12-month follow-up period. METHODS: Forty-seven adult TM patients (median age: 36 years, 57% men) without overt heart failure were studied. We examined 12-lead electrocardiograms, 24-hour electrocardiographic Holter recordings, and treadmill exercise stress tests at baseline and after 12 months. Conventional electrocardiographic measurements, as well as contemporary indexes of depolarization and repolarization/dispersion of repolarization (QRS fragmentation; T peak-to-end; T peak-to-end/QT) were assessed. Moreover, we examined markers of autonomic dysfunction such as heart rate variability, and heart rate recovery after exercise testing. RESULTS: The electrocardiographic markers of atrial/ventricular depolarization and repolarization, as well as indexes of autonomic imbalance, were not significantly changed. However, the recorded supraventricular ectopic beats increased significantly. Paroxysmal atrial fibrillation (PAF) detection was greater in 12 months (4/47 at baseline vs. 8/47 at 12 months; P=0.38). However, 5/8 patients who were diagnosed with PAF at the second examination did not have the arrhythmia at the initial evaluation. Thus, PAF was present in a total of 9/47 (19%) TM patients. Notably, 3/9 of the patients were asymptomatic. The mean duration of PAF was 5±2 minutes and the mean number of these episodes was 8±2. CONCLUSION: TM patients have repolarization and autonomic function abnormalities that do not significantly change during a 12-month follow-up period. However, supraventricular ectopy and AF burden further evolve. AJCD
Authors: Vincenzo Russo; Anna Rago; Bruno Pannone; Andrea Antonio Papa; Maria Carolina Mayer; Anna Spasiano; Raffaele Calabro; Maria Giovanna Russo; Nigro Gerardo Journal: Indian Pacing Electrophysiol J Date: 2014-05-25