ECG changes in patients with liver cirrhosis

Introduction: A prolonged QT interval is the most common ECG abnormality seen in patients with liver cirrhosis. Even though the incidence of lethal ventricular arrhythmias is low in these patients, a prolonged corrected QT interval correlates with a decreased survival. The aim of this study was to characterize the ECG changes in a group of patients with liver cirrhosis admitted to the 3rd Medical Clinic from Cluj-Napoca. Methods: One hundred nine patients (66 men), consecutive cases, with a mean age of 56.8 ± 10.6 years (25 – 81) diagnosed with liver cirrhosis, admitted to the 3rd Medical Clinic from Cluj-Napoca between January 2007 and December 2008, were included in the study. All patients underwent a complete physical examination and a resting 12-lead ECG. Th e etiology of liver cirrhosis in these patients was ethanolic in 47 cases (43.1%), viral in 42 (38.5%), ethanolic/virus in 6 (5.5%), and 14 patients had other causes. Most of the patients (77.9%) were in Child-Pugh class A. Forty-seven patients were treated with low doses of beta-blocker. Results: The average value of the QTFridericia was 411.1 ± 0.0 ms. QTFridericia was prolonged (> 452 ms) in 12 patients (12.8%), with an average of 469.6 ± 15.2 ms. The QTFridericia value was higher in women (472.5 ms vs 466.6 ms, p = 0.2). Most of the patients were in sinus rhythm (96.3%). Fifty-one patients (46.8%) had arrhythmias and conduction disturbances. The arrhythmias found were: atrial fi brillation (n = 4), supraventricular (n = 3) and ventricular extrasystoles (n = 6), sinus bradycardia (n = 15) and sinus tachycardia (n = 7). Eight patients had incomplete RBBB, 2 complete LBBB and 6 LAHB. Of all patients, 10 had low voltage QRS (10.9%), of which only nine in limb leads (≤ 5 mm) and one patient in limb and precordial leads (≤ 10 mm). Conclusions: Patients with liver cirrhosis often have electrocardiographic abnormalities. The 12 lead ECG is a simple method, useful for their identification.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)