title: Carbon monoxide poisoning increases Tpeak-Tend dispersion and QTc dispersion.
abstract: OBJECTIVE
  Carbon monoxide (CO) poisoning leads to cardiac dysrhythmia. Increased heterogeneity in ventricular repolarisation on electrocardiogram (ECG) shows an increased risk of arrhythmia. A number of parameters are used to evaluate ventricular repolarisation heterogeneity on ECG. The aim of our study is to investigate the effect of acute CO poisoning on indirect parameters of ventricular repolarisation on ECG.
  
  
  METHODS
  Sixty-seven patients were included in this case-control study. Thirty patients with acute CO poisoning were assigned to group 1 (19 females, mean age: 30.8 ± 11.3 years). A control group was formed with patients without known cardiac disease (group 2, n = 37; 25 females, mean age: 26.0 ± 5.2 years). Twelve-lead ECG and serum electrolyte levels were recorded in all patients. Also, carboxyhaemoglobin (COHb) levels were recorded in group 1. Tpeak-Tend (TpTe) interval, TpTe dispersion, TpTe/QT ratio, QT interval and QTd durations were measured as parameters of ventricular repolarisation. Corrected QT (QTc ) and QTc dispersion (QTcd) intervals were determined with the Bazett's formula.
  
  
  RESULTS
  The mean COHb level in group 1 was 27.6 ± 7.4% and mean duration of CO exposure was 163.5 ± 110.9 min. No statistically significant difference was found in age, gender, serum electrolytes or blood pressure levels between the groups. QRS, QT, QTc, TpTe interval and TpTe/QT ratio were similar between the groups (p > 0.05). QTcd (65.7 ± 64.4 vs 42.1 ± 14.2 ms, p = 0.003) and TpTe dispersion (40.5 ± 14.8 vs 33.2 ± 4.9 ms, p = 0.006) were significantly longer in group 1 than group 2. COHb level was moderately correlated with TpTe dispersion (r = 0.29; p = 0.01).
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to investigate TpTe interval and dispersion in CO poisoning. Our results showed that TpTe dispersion and QTc dispersion increased after CO poisoning.
authors.affiliation: Department of Emergency Medicine, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey. drmeroglu@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Eroglu
authors.affiliation: Department of Cardiology, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Uz
authors.affiliation: Department of Cardiology, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Isilak
authors.affiliation: Department of Cardiology, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yalcin
authors.affiliation: Department of Emergency Medicine, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey.
authors.forename: Ali Osman
authors.initials: AO
authors.lastname: Yildirim
authors.affiliation: Department of Cardiology, Haydarpasa Teaching Hospital, Gulhane Military Medical Academy, Istanbul, Turkey.
authors.forename: Ejder
authors.initials: E
authors.lastname: Kardesoglu
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D001795:Blood Pressure Determination / Q000379:methods; D002249:Carbon Monoxide Poisoning / Q000503:physiopathology*; D016022:Case-Control Studies; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged