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Atrial and ventricular arrhythmia predictors with electrocardiographic parameters in myocardial infarction with
Serkan Asil1, Muhammet Geneş1, Salim Yaşar1
1Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Turkey.
Insights
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) patients show no increased risk for atrial fibrillation. However, MINOCA is linked to a higher risk of ventricular arrhythmia, suggesting closer monitoring for these patients.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasingly recognized.
- The risk of atrial fibrillation and ventricular arrhythmia in MINOCA patients remains understudied.
Purpose of the Study:
- To investigate the risk of atrial and ventricular arrhythmias in MINOCA patients.
- To identify electrocardiographic predictors for arrhythmias in MINOCA.
Main Methods:
- Compared 77 MINOCA patients with stable outpatients without significant coronary lesions.
- Assessed atrial arrhythmia risk using the Morphology-Voltage-P wave duration (MPV) ECG score.
- Evaluated ventricular arrhythmia risk using QT interval, QT dispersion, Tpeak-Tend time, and Tpeak-Tend/QT interval ratios.
Main Results:
- No significant difference in MPV ECG scores between groups (p=0.128).
- MINOCA patients exhibited significantly higher QRS duration (p=0.017), shorter ST interval (p<0.001), prolonged corrected QT interval (p=0.005), and increased QT dispersion (p<0.001).
- MINOCA patients showed significantly higher Tpeak-Tend (p<0.001) and Tpeak-Tend/QT ratios (p<0.001).
Conclusions:
- MINOCA patients do not show an increased risk of atrial fibrillation based on ECG predictors.
- A significant increase in the risk of ventricular arrhythmia is observed in MINOCA patients.
- Findings may inform recommendations for hospitalization duration and follow-up for MINOCA patients.
Background:
The clinical importance and recognition of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasing. Nevertheless, no studies are investigating the risk of atrial fibrillation and ventricular arrhythmia in MINOCA patients. This study aimed to determine the risk of arrhythmia with electrocardiographic predictors in MINOCA patients.
Methods:
In this study, patients diagnosed with MINOCA and stable out-patients without significant lesions in their coronary arteries were compared. Morphology-voltage-Pwave duration electrocardiography (MPV ECG) score was used to determine atrial arrhythmia risk. QT interval and QT dispersion Tpeak-Tend time and Tpeak-Tend/QT interval were used to determine ventricular arrhythmia risk.
Results:
A total of 155 patients were included in our study. Seventy-seven of these patients were in the MINOCA group. There was no statistically significant difference between the two groups in MPV ECG score (1.95 ± 1.03 vs 1.68 ± 1.14, p = 0.128). P-wave voltage, P-wave morphology and P-wave duration, which are components of the MPV ECG score, were not statistically significantly different. The QRS complex duration (90.21 ± 14.87 vs 82.99 ± 21.59 ms, p = 0.017), ST interval (271.95 ± 45.91 vs 302.31 ± 38.40 ms, p < 0.001), corrected QT interval (438.17 ± 43.80 vs 421.41 ± 28.39, p = 0.005) and QT dispersion (60.75 ± 22.77 vs 34.19 ± 12.95, p < 0.001) were statistically significantly higher in the MINOCA group. The Tpeak-Tend (89.53 ± 32.16 vs 65.22 ± 18.11, p < 0.001), Tpeak-Tend/QT interval (0.2306 ± 0.0813 vs 0.1676 ± 0.0470, p < 0.001) and Tpeak-Tend/corrected QT interval (0.2043 ± 0.6997 vs 0.1551 ± 0.4310, p < 0.001) ratios were also significantly higher in patients with MINOCA.
Conclusions:
In the MINOCA patients, there was no increase in the risk of atrial fibrillation based on ECG predictors. However, it was shown that there could be a significant increase in the risk of ventricular arrhythmia. We believe this study could be helpful for specific recommendations concerning duration of hospitalisation and follow up in MINOCA patients.
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