QT Interval Prolongation in Patients with Systemic Sclerosis-Are the Holter ECG Recordings a Better Option for QT
Elena E Saramet1, Doina-Clementina Cojocaru1, Sorin Ungurianu2
1Department of Internal Medicine, Gr T Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
Systemic sclerosis patients show prolonged QT intervals and ventricular ectopy on 24-hour Holter ECG, indicating cardiac involvement. This method offers a more precise cardiac risk assessment than short ECGs.
Area of Science:
- Cardiology
- Rheumatology
- Medical Diagnostics
Background:
- Cardiac involvement in systemic sclerosis significantly impacts patient survival.
- Myocardial fibrosis and microcirculation issues can lead to arrhythmias and increased mortality risk.
- QT interval prolongation is a known risk factor for ventricular arrhythmias.
Purpose of the Study:
- To compare the diagnostic accuracy of standard ECG versus 24-hour Holter ECG monitoring for evaluating cardiac involvement in systemic sclerosis.
- To assess QT interval prolongation and ventricular ectopic events in systemic sclerosis patients.
Main Methods:
- 39 patients with systemic sclerosis underwent both standard ECG and 24-hour Holter ECG monitoring.
- Analysis focused on QT interval duration and the presence of ventricular ectopy.
Main Results:
- 24-hour Holter ECG monitoring revealed significantly higher QT interval values compared to standard ECG.
- Holter monitoring detected ventricular ectopy in patients with normal standard ECG findings.
- This highlights the sensitivity of Holter monitoring in identifying subclinical cardiac issues.
Conclusions:
- 24-hour Holter ECG provides a more accurate assessment of QTc interval prolongation in systemic sclerosis.
- Holter monitoring is superior for detecting ventricular ectopic events related to myocardial involvement in systemic sclerosis.
- This improved diagnostic capability can aid in risk stratification and patient management.
Abstract:
Background and Objectives: Cardiac involvement in systemic sclerosis has important consequences on patient survival. Myocardial fibrosis and microcirculation involvement can generate arrhythmic complications, which can be associated with a higher death risk. QT interval prolongation is considered as a risk factor for ectopic ventricular events and can be evaluated using standard short ECG recordings or 24-h Holter ECG recordings. Materials and Methods: 39 patients with systemic sclerosis were submitted to a standard ECG recording at admission and 24-h Holter ECG monitoring. Results: QT interval values resulted from Holter ECG monitoring are higher than the values generated by the short-term ECG recordings. Holter ECG monitoring permits the detection of ventricular ectopy in patients with no events on standard ECG. Conclusions: In patients with systemic sclerosis, 24-h Holter ECG recordings can realize a more precise evaluation of the extent of QTc interval prolongation and ventricular ectopic events associated with myocardial involvement.
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