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Electrocardiographic abnormalities associated with malignant hyperthermia susceptibility

V F Huckell, H M Staniloff, B A Britt

    Journal of Electrocardiology
    |April 1, 1982
    PubMed
    Summary

    Abnormal ECGs may indicate susceptibility to malignant hyperthermia (MH) in patients without prior crises. This study found cardiac abnormalities in over 25% of MH-susceptible individuals.

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    Area of Science:

    • Anesthesiology
    • Cardiology
    • Genetics

    Background:

    • Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle.
    • Susceptibility can be diagnosed via muscle biopsy but often remains undetected in individuals without prior hyperpyrexic crises.
    • Electrocardiography (ECG) is a non-invasive tool for cardiac assessment.

    Purpose of the Study:

    • To investigate the prevalence of electrocardiographic (ECG) abnormalities in patients susceptible to malignant hyperthermia (MH) but without a history of MH crises.
    • To determine if ECG findings can serve as a potential indicator of MH susceptibility.

    Main Methods:

    • Serial ECGs were reviewed in 93 patients diagnosed with MH susceptibility through caffeine contracture and ATP depletion tests.
    • Patients had no documented history of pyrexic crises.

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  • ECG findings were analyzed for abnormalities, including conduction defects, repolarization changes, and increased voltages.

    • Main Results:

    • Abnormal ECGs were identified in 26 out of 93 (28%) MH-susceptible patients.
    • Common abnormalities included conduction defects (14 patients), repolarization abnormalities or Q waves (9 patients), and increased voltages suggesting left ventricular hypertrophy (3 patients).
    • These abnormalities were observed in the absence of hypertension.

    Conclusions:

    • A significant proportion of individuals susceptible to malignant hyperthermia exhibit abnormal ECG findings, even without a history of MH crises.
    • Electrocardiographic abnormalities may represent a subclinical manifestation of MH susceptibility.
    • ECG screening could potentially aid in identifying individuals at risk for malignant hyperthermia.