Evaluation of index of cardiac-electrophysiological balance in patients with subarachnoid hemorrhage

Seyho Cem Yücetas; Hakan Kaya; Safiye Kafadar; Huseyin Kafadar; Hakan Tibilli; Ahmet Akcay

doi:10.1186/s12872-022-02924-y

Evaluation of index of cardiac-electrophysiological balance in patients with subarachnoid hemorrhage

BMC Cardiovasc Disord. 2022 Nov 10;22(1):477. doi: 10.1186/s12872-022-02924-y.

Authors

Seyho Cem Yücetas¹, Hakan Kaya², Safiye Kafadar³, Huseyin Kafadar⁴, Hakan Tibilli², Ahmet Akcay²

Affiliations

¹ Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey.
² Department of cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey.
³ Department of Radiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey.
⁴ Department of Forensic Medicine, Harran University Research Hospital, Sanliurfa, Turkey. dr.hkafadar@gmail.com.

Abstract

Background: Various electrocardiographic (ECG) changes occur after subarachnoid hemorrhage (SAH). Prolonged QT and corrected QT (QTc) intervals are notable changes. QT, QTc, T peak-to-end T(p-e) intervals, and Tp-e/QTc ratio are used as ventricular arrhythmia indices. In recent publications, the cardiac electrophysiological balance index (ICEB), which provides more information than other ECG parameters (QT, QTc, etc.), is recommended in predicting the risk of ventricular arrhythmia. This study aims to assess ICEB in aneurysmal SAH patients.

Methods: The study included 50 patients diagnosed with aneurysmal SAH and 50 patients diagnosed with hypertension without end-organ damage as the control group. All patients' Fisher scores and Glasgow Coma Scale (GCS) scores were recorded. Both groups were given 12-lead ECGs. QT, QTc, Tp-e intervals, QRS duration, ICEB (QT/QRS), ICEBc (QTc/QRS), and T(p-e)/QTc values were calculated and analyzed between groups.

Results: Compared to the control group; QT (426,64 ± 14,62 vs. 348,84 ± 12,24 ms, p < 0,001), QTc (456,24 ± 28,84 vs. 392,48 ± 14,36 ms, p < 0,001), Tp-e (84,32 ± 3,46 vs. 70,12 ± 3,12, p < 0,001), Tp-e/QTc (0,185 ± 0,08 vs. 0,178 ± 0,02, p < 0,001), ICEB (4,53 ± 0,78 vs. 3,74 ± 0,28, p < 0,001) and ICEBc (4,86 ± 0,86 vs. 4,21 ± 0,24, p < 0,001) were significantly higher in patients with aneurysmal SAH. QT, QTc and Tp-e interval, Tp-e/QTc ratio, ICEB (QT/QRS) and ICEBc (QTc/QRS) were positively correlated with the Fisher score and were negatively correlated with the GCS. According to linear regression analyses, the ICEBc (QTc/QRS) found to be independently associated with the Fisher score.

Conclusion: The values of the ICEB and ICEBc were significantly increased in patients with aneurysmal SAH. The severity of SAH was positively correlated with the ICEB and ICEBc. The ICEBc (QTc/QRS) independently associated with the Fisher score. This may that SAH suggest may predispose to malignant ventricular arrhythmias.

Keywords: Index of cardiac electrophysiological balance; Subarachnoid hemorrhage; Ventricular arrhythmia.

MeSH terms

Arrhythmias, Cardiac
Electrocardiography
Humans
Hypertension*
Long QT Syndrome*
Subarachnoid Hemorrhage* / complications
Subarachnoid Hemorrhage* / diagnosis