Related Experiment Video
Updated: Jun 26, 2025
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
A Study on QT Dispersion before and after Thrombolysis in Acute Myocardial Infarction and its Prognostic
Apoorva M1, Harshwardhan Khandait2, Chinmay Guralwar3
1DM Cardiology Resident, Department of Cardiology, U N Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat, India.
Insights
Successful thrombolysis significantly reduces QT dispersion (QTd) in acute myocardial infarction (AMI) patients, lowering arrhythmia risk. This reduction in QTd also serves as a reliable predictor of arrhythmias following myocardial infarction.
Area of Science:
- Cardiology
- Clinical Electrophysiology
- Acute Myocardial Infarction Research
Background:
- Acute myocardial infarction (AMI) is a critical complication of coronary artery disease.
- QT dispersion (QTd) is a noninvasive marker for predicting mortality in high-risk myocardial infarction (MI) patients.
- Understanding QT interval changes post-thrombolysis is crucial for managing AMI.
Purpose of the Study:
- To measure QT, corrected QT (QTc), QT dispersion (QTd), and corrected QT dispersion (QTcd) intervals before and after thrombolysis in AMI patients.
- To evaluate the prognostic implications of QTd in patients with AMI.
- To assess the impact of thrombolysis on QT parameters and arrhythmia risk.
Main Methods:
- A before-and-after comparison study conducted in a tertiary care center's ICU.
- 160 patients with ST-elevation myocardial infarction (STEMI) undergoing thrombolysis were enrolled.
- QT, QTc, QTd, and QTcd intervals were measured at admission and post-thrombolysis.
Main Results:
- Hypertension was the most common risk factor (68 patients).
- QT, QTd, and QTcd showed significant statistical variation (p < 0.0001) after thrombolysis.
- Higher admission QT parameters correlated with mortality, while lower values correlated with discharge; a significant correlation (p < 0.0001) existed between arrhythmias and patient outcomes.
Conclusions:
- Successful thrombolysis significantly decreases QTd, reducing arrhythmogenic potential in AMI patients.
- QTd can serve as a reliable predictor of arrhythmias in patients with myocardial infarction.
- Thrombolysis positively impacts QT parameters and patient outcomes.
Abstract:
Introduction: Acute myocardial infarction (AMI) stands as one of the most catastrophic occurrences in the progression of coronary artery disease. Measuring QT dispersion (QTd) is a fairly straightforward and noninvasive technique for predicting mortality in patients at high risk following a myocardial infarction (MI). Objective: To measure the QT, corrected QT interval (QTc), QTd, and corrected QT dispersion (QTcd) intervals before and after thrombolysis in patients with AMI and to determine prognostic implications of QTd in AMI. Materials and methods: This was a before and after comparison study conducted in the intensive care unit (ICU) of a tertiary care center in Central India. It was carried out in patients with AMI [ST-elevation myocardial infarction (STEMI)] who underwent thrombolysis in ICU. A total of 160 participants were enrolled over the time period of 24 months using the convenience sampling technique. Results: The most prevalent (68 patients) risk factor among MI patients was hypertension (HTN). QT parameters such as QT, QTd, and QTcd showed significant statistical variation of p-value < 0.0001 when compared at admission and after thrombolysis. No significant difference (p > 0.05) in QT parameters at admission (QTd, QTc, and QTcd) between anterior and inferior wall MI, except for QT interval (p = 0.0010). Among the 33 patients who experienced arrhythmia, ventricular tachycardia was the most prevalent arrhythmia in 22 patients (13.75%). There was a significant statistical correlation between the arrhythmic event and the outcome of the patient (p < 0.0001). Patients who died had higher QT parameter values at admission, and these remained on the higher side even after thrombolysis, whereas those who got discharged had lower QT parameter values at admission, and their values decreased after thrombolysis. Conclusion: Successful thrombolysis significantly decreases the QTd and thereby the arrhythmogenic potential, and thus can also be used as a reliable predictor of arrhythmia in patients of MI. How to cite this article: M A, Khandait H, Guralwar C, et al. A Study on QT Dispersion before and after Thrombolysis in Acute Myocardial Infarction and its Prognostic Implications: A before and after Comparison Study. J Assoc Physicians India 2023;71(10):14-18.
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:16Clot Retraction and Fibrinolysis