title: Arrhythmias and Electrocardiographic Changes in Systolic Heart Failure.
abstract: BACKGROUND
  Heart failure is a common condition that that leads to hospitalization. It is associated with various atrial and ventricular arrhythmias.
  
  
  OBJECTIVE
  The aim of this study is to find common arrhythmias and electrocardiographic changes in hospitalized patients who have systolic heart failure.
  
  
  METHODS
  This is a retrospective study of medical records, and electrocardiograms (EKGs) of 157 patients admitted to our hospital who had systolic heart failure with ejection fraction (EF) <50% on echocardiogram. Based on EF, the patients were divided into two groups; one with EF ≤ 35% and the other with EF > 35%. Twelve-lead EKG of these patients was studied to identify common arrhythmia and demographic variables; laboratory results were compared to identify the differences.
  
  
  RESULTS
  A total of 157 patients with systolic heart failure, 63.7% had an EF ≤ 35%. Hypertension 82.8%, diabetes 49%, coronary artery disease 40.8%, chronic obstructive pulmonary disease or bronchial asthma 22.3%, and stroke 12.1% were common associated co-morbidities. On analysis of EKG, 28.6% had tachycardia, 21.9% had prolonged PR > 200 ms, 16.3% had wide QRS > 120 ms, 70.7% had prolonged corrected QT (QTc), and 42.2% had left axis deviation. The most common arrhythmias were sinus tachycardia and atrial fibrillation/flutter which were found in 14.6% and 13.4%, respectively. The left ventricular hypertrophy was a common abnormality found in 22.4% followed by ventricular premature contractions 18.4%, atrial premature contractions 9.5%, and left bundle branch block 6.1%. Patients with severe systolic heart failure had prolonged QRS (P = 0.02) and prolonged QTc (P = 0.01) as compared to the other group.
  
  
  CONCLUSIONS
  Sinus tachycardia and atrial fibrillation/flutter were common arrhythmias in patients with systolic heart failure. Patients with severe systolic heart failure had statistically significant prolongation of the QRS duration and QTc interval.
authors.affiliation: Department of Medicine , Cardiology Division , Interfaith Medical Center, Brooklyn, NY , USA.
authors.forename: Ashok
authors.initials: A
authors.lastname: Devkota
authors.affiliation: Department of Medicine , Cardiology Division , Interfaith Medical Center, Brooklyn, NY , USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Bakhit
authors.affiliation: Department of Internal Medicine, Cardiology Division , Interfaith Medical Center , Brooklyn, NY , USA.
authors.forename: Alix
authors.initials: A
authors.lastname: Dufresne
authors.affiliation: Department of Medicine , Cardiology Division , Interfaith Medical Center, Brooklyn, NY , USA.
authors.forename: Aung Naing
authors.initials: AN
authors.lastname: Oo
authors.affiliation: Department of Medicine , Cardiology Division , Interfaith Medical Center, Brooklyn, NY , USA.
authors.forename: Premraj
authors.initials: P
authors.lastname: Parajuli
authors.affiliation: Department of Medicine , Cardiology Division , Interfaith Medical Center, Brooklyn, NY , USA.
authors.forename: Saveena
authors.initials: S
authors.lastname: Manhas
keywords: Atrial fibrillation; QRS duration; corrected QT interval; electrocardiogram; systolic heart failure