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Twelve-lead and signal-averaged electrocardiographic parameters among beta-thalassemia major patients

Dimitrios Patsourakos1, Konstantinos A Gatzoulis2, Constantina Aggeli2

  • 1State Department of Cardiology General Hospital of Athens Ippokrateio Athens Greece.

Journal of Arrhythmia
|October 7, 2020
PubMed

Insights

Beta thalassemia major patients show increased cardiac electrical abnormalities, including prolonged PR intervals and late potentials. Signal-averaged electrocardiography is a valuable tool for assessing these risks.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Hematology

Background:

  • Beta-thalassemia major (β-TM) is associated with significant cardiac disease and sudden death.
  • Cardiac complications in β-TM patients necessitate effective diagnostic tools.

Purpose of the Study:

  • To evaluate the utility of 12-lead and signal-averaged electrocardiography (SAECG) in identifying arrhythmiogenic substrates in β-TM patients.
  • To assess electrocardiographic parameters and the prevalence of late potentials (LPs) in β-TM patients compared to healthy controls.

Main Methods:

  • 47 β-TM patients and 30 healthy controls underwent 12-lead and SAECG.
  • Echocardiography and cardiac MRI (T2*) were used to assess cardiac structure and function.
  • Prevalence of LPs and basic electrocardiographic parameters were recorded.

Main Results:

  • β-TM patients exhibited prolonged PR intervals (P=.043) and a higher prevalence of PR prolongation (P=.013) compared to controls.
  • Late potentials (LPs) were significantly more prevalent in β-TM patients (38.3% vs 6.7%, P=.002).
  • Higher E/e' ratio (P=.012) and left atrial volume index (LAVI) (P=.002) were observed in β-TM patients. QTc and LAVI predicted LPs in 80.9% of patients.

Conclusions:

  • β-TM patients demonstrate a higher incidence of prolonged PR intervals, atrial fibrillation, and LPs.
  • 12-lead and SAECG are feasible and effective tools for assessing myocardial electrophysiological alterations in β-TM.
  • These ECG findings highlight the importance of SAECG for risk stratification in β-TM patients.
Abstract

Keywords:
beta thalassemialate potentialsrisk stratificationsignal‐averaged ECGsudden cardiac death

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