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Electrocardiographic Repolarization Changes Following Orchiectomy: Insights Into QT Interval Prolongation and
Yuta Sakaguchi1, Kenichi Iijima2, Naomasa Suzuki1
1Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Introduction:
Sex steroid hormones influence ventricular repolarization and QT interval duration. Testosterone has been associated with shorter QT intervals, whereas androgen deprivation may prolong repolarization indices. However, the effects of orchiectomy on ECG parameters in humans remain insufficiently characterized.
Methods:
We conducted a retrospective analysis of 233 consecutive patients who underwent orchiectomy at our hospital between 2006 and 2021. ECG parameters were compared in 44 patients who had ECG recorded both before and after surgery. Furthermore, the effects of surgery were stratified by unilateral (n = 20) and bilateral orchiectomy (n = 24) groups to assess differential effects.
Results:
The mean age was 59.5 years old. Patients in the unilateral group were significantly younger, taller, and heavier (p < 0.05). Orchiectomy was performed for prostate cancer in 22 patients (50%) and for testicular tumors in 19 patients (43%). No significant differences were observed in QRS width before and after surgery. However, QT and corrected QT (QTc) intervals were significantly prolonged following orchiectomy (QT 383 ± 42 to 403 ± 42 ms, p < 0.01, QTc 416 ± 35 to 433 ± 35 ms, p < 0.001). Post-surgery, there were no significant differences in the QT and QTc interval prolongation between the two groups.
Conclusion:
Orchiectomy was associated with prolongation of QT/QTc intervals, particularly after bilateral orchiectomy. These findings suggest that patients after orchiectomy may be more susceptible to additional factors that prolong ventricular repolarization, including electrolyte abnormalities and QT-prolonging medications. Careful ECG monitoring may be warranted in selected patients.
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