title: Acute electrocardiographic changes during smoking: an observational study.
abstract: OBJECTIVE
  To study the temporal relationship of smoking with electrophysiological changes.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Tertiary cardiac center.
  
  
  METHODS
  Male smokers with atypical chest pain were screened with a treadmill exercise test (TMT). A total of 31 such patients aged 49.8±10.5 years, in whom TMT was either negative or mildly positive were included. Heart rate variability (HRV) parameters of smokers were compared to those of 15 healthy non-smoking participants.
  
  
  METHODS
  All patients underwent a 24 h Holter monitoring to assess ECG changes during smoking periods.
  
  
  RESULTS
  Heart rate increased acutely during smoking. Mean heart rate increased from 83.8±13.7 bpm 10 min before smoking, to 90.5±16.4 bpm during smoking, (p<0.0001) and returned to baseline after 30 min. Smoking was also associated with increased ectopic beats (mean of 5.3/h prior to smoking to 9.8/h during smoking to 11.3/h during the hour after smoking; p<0.001). Three patients (9.7%) had significant ST-T changes after smoking. HRV index significantly decreased in smokers (15.2±5.3) as compared to non-smoking controls participants (19.4±3.6; p=0.02), but the other spectral HRV parameters were comparable.
  
  
  CONCLUSIONS
  Heart rate and ectopic beats increase acutely following smoking. Ischaemic ST-T changes were also detected during smoking. Spectral parameters of HRV analysis of smokers remained in normal limits, but more importantly geometrical parameter-HRV index-showed significant abnormality.
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sivasubramanian
authors.initials: S
authors.lastname: Ramakrishnan
authors.forename: Kinjal
authors.initials: K
authors.lastname: Bhatt
authors.forename: Akhilesh K
authors.initials: AK
authors.lastname: Dubey
authors.forename: Ambuj
authors.initials: A
authors.lastname: Roy
authors.forename: Sandeep
authors.initials: S
authors.lastname: Singh
authors.forename: Nitish
authors.initials: N
authors.lastname: Naik
authors.forename: Sandeep
authors.initials: S
authors.lastname: Seth
authors.forename: Balram
authors.initials: B
authors.lastname: Bhargava
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