Electrocardiogram Changes with Acute Alcohol Intoxication: A Systematic Review

Raheja, Hitesh; Namana, Vinod; Chopra, Kirti; Sinha, Ankur; Gupta, Sushilkumar Satish; Kamholz, Stephan; Moskovits, Norbert; Shani, Jacob; Hollander, Gerald

doi:10.2174/1874192401812010001

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…However, what appears to be consistent among all studies is the association between ethanol blood levels and ECG changes, i.e. directly related to the period of emergency department admission and ECG checks [16][17][18].…”

Section: Discussionmentioning

confidence: 54%

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Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

Dorooshi

Savari

Nayeri

et al. 2021

IJMTFM

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Background: Alcohol consumption leads to a significant number of deaths, mostly in men, worldwide. Considering the effect of ethanol toxicity on the heart, we studied various Electrocardiographic (ECG) changes in patients with acute ethanol poisoning. Methods: A cross-sectional study was performed on patients admitted to Khorshid Hospital (affiliated to Isfahan University of Medical Sciences) due to ethanol poisoning. All 15- to 50-year-old patients with acute ethanol intoxication were included in the study (N=250). The patients’ information, including the demographic characteristics, clinical manifestations, and ECG changes were recorded and analyzed. Different variables were compared between the patients with or without ECG changes. Results: Most of the research patients (n=208) were men (83.82%). The Mean±SD age of the study patients was 26.8±8.87 years. About 54.8% of the patients presented abnormal ECG. The changes in ECG were not significantly different based on the demographic characteristic and clinical manifestations. The time interval between ethanol consumption and admission was significantly higher in patients with abnormal ECG, compared to those with normal ECG (Mean±SD: 7.09±10.67 vs. 4.77± 4.54 hours, respectively) (P=0.03). Conclusion: ECG changes are common in patients with ethanol poisoning. The time interval between ethanol consumption to hospital admission may be an important factor in the occurrence of ECG changes.

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Section: Discussionmentioning

confidence: 54%

“…A systematic review in 2018 documented that the most common ECG changes with acute alcohol intoxication are P-wave and QTc prolongation, followed by T-wave abnormalities and QRS complex prolongation. However, most of these findings are completely reversible [18].…”

Section: Discussionmentioning

confidence: 99%

Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

Dorooshi

Savari

Nayeri

et al. 2021

IJMTFM

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“…Given that heavy alcohol consumption and/or withdrawal is a risk factor for QTc prolongation 25 – 27 , P wave prolongation 28 , and ischemic heart disease mortality 29 , use of a cardiac-safe agent with co-occurring PT 150-alcohol use and evaluation of any drug–drug interaction effects on ECG are important. Although we observed a general decreasing trend in many ECG measures over time compared to the pre-PT150 baseline measure, changes were not deemed clinically significant.…”

Section: Discussionmentioning

confidence: 99%

A randomized trial of safety and pharmacodynamic interactions between a selective glucocorticoid receptor antagonist, PT150, and ethanol in healthy volunteers

Morice

Baker

Patel

et al. 2021

Sci Rep

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PT150, a novel competitive glucocorticoid receptor (GR) antagonist, has proven safe in animal models, healthy volunteers, and people with depression. Our study is the first to investigate PT150’s safety with alcohol use. The primary objective of this study was to evaluate pharmacodynamic interactions between ethanol and PT150 in healthy subjects. This single-site, Phase I pilot trial consisted of community-recruited, healthy, alcohol-experienced participants aged 21–64 years. Of 32 participants screened, 11 were enrolled and randomized, one of which withdrew before intervention. PT150 (900 mg/day) was administered orally to all participants for five days. All participants received two beverage challenges on Day 1 (before PT150 administration) and Day 5 (after PT150 administration). On challenge days, they received both alcohol (16% ethanol) and placebo (1% ethanol) beverages in random order. Primary outcomes included breath alcohol level, blood pressure, heart rate, adverse events, and electrocardiogram changes. There were no statistically significant differences in vital signs or estimated blood alcohol concentrations between PT150 non-exposed and exposed groups during the ethanol challenge. There were no clinically significant abnormal electrocardiograms or serious adverse events. These data show that administration of PT150 with concurrent alcohol use is safe and well-tolerated. This study supports a future pharmacokinetic interaction study between PT150 and alcohol.Trial Registration ClinicalTrials.gov Identifier: NCT03548714.

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“…QTc value higher than 500 ms increases the probability of cardiac events [32]. Several factors affect QTc interval, and a significant prolongation in QTc interval with sensitization of the myocardium to cardiac arrhythmias including life-threatening ventricular arrhythmias has also been noted in alcohol intoxicated patients [33]. Importantly, these effects strongly depend on the dose of alcohol [34], as alcohol increases plasma osmolality in a dose-dependent manner [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients

Dąbrowski

Siwicka-Gieroba

Robba

et al. 2020

JCM

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Introduction: Hyperosmotic therapy with mannitol is frequently used for treatment cerebral edema, and 320 mOsm/kg H2O has been recommended as a high limit for therapeutic plasma osmolality. However, plasma hyperosmolality may impair cardiac function, increasing the risk of cardiac events. The aim of this study was to analyze the relation between changes in plasma osmolality and electrocardiographic variables and cardiac arrhythmia in patients treated for isolated traumatic brain injury (iTBI). Methods: Adult iTBI patients requiring mannitol infusion following cerebral edema, and with a Glasgow Coma Score below 8, were included. Plasma osmolality was measured with Osmometr 800 CLG. Spatial QRS-T angle (spQRS-T), corrected QT interval (QTc) and STJ segment were calculated from digital resting 12-lead ECGs and analyzed in relation to four levels of plasma osmolality: (A) <280 mOsm/kg H2O; (B) 280–295 mOsm/kg H2O; (C) 295–310 mOsm/kg H2O; and (D) >310 mOsm/kg H2O. All parameters were measured during five consecutive days of treatment. Results: 94 patients aged 18-64 were studied. Increased plasma osmolality correlated with prolonged QTc (p < 0.001), intensified disorders in STJ and increased the risk for cardiac arrhythmia. Moreover, plasma osmolality >313 mOms/kg H2O significantly increased the risk of QTc prolongation >500 ms. Conclusion: In patients treated for iTBI, excessively increased plasma osmolality contributes to electrocardiographic disorders including prolonged QTc, while also correlating with increased risk for cardiac arrhythmias.

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Electrocardiogram Changes with Acute Alcohol Intoxication: A Systematic Review

Cited by 15 publications

References 28 publications

Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

A randomized trial of safety and pharmacodynamic interactions between a selective glucocorticoid receptor antagonist, PT150, and ethanol in healthy volunteers

Plasma Hyperosmolality Prolongs QTc Interval and Increases Risk for Atrial Fibrillation in Traumatic Brain Injury Patients

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