Evaluation of index of cardiac-electrophysiological balance in patients with subarachnoid hemorrhage

Abstract

Background Various electrocardiographic (ECG) changes occur after subarachnoid hemorrhage (SAH). Prolonged QT and corrected QT (QTc) intervals are notable changes. QT, QTc, T peak-to-end T(p-e) intervals, and Tp-e/QTc ratio are used as ventricular arrhythmia indices. In recent publications, the cardiac electrophysiological balance index (ICEB), which provides more information than other ECG parameters (QT, QTc, etc.), is recommended in predicting the risk of ventricular arrhythmia. This study aims to assess ICEB in aneurysmal SAH patients. Methods The study included 50 patients diagnosed with aneurysmal SAH and 50 patients diagnosed with hypertension without end-organ damage as the control group. All patients’ Fisher scores and Glasgow Coma Scale (GCS) scores were recorded. Both groups were given 12-lead ECGs. QT, QTc, Tp-e intervals, QRS duration, ICEB (QT/QRS), ICEBc (QTc/QRS), and T(p-e)/QTc values were calculated and analyzed between groups. Results Compared to the control group; QT (426,64 ± 14,62 vs. 348,84 ± 12,24 ms, p < 0,001), QTc (456,24 ± 28,84 vs. 392,48 ± 14,36 ms, p < 0,001), Tp-e (84,32 ± 3,46 vs. 70,12 ± 3,12, p < 0,001), Tp-e/QTc (0,185 ± 0,08 vs. 0,178 ± 0,02, p < 0,001), ICEB (4,53 ± 0,78 vs. 3,74 ± 0,28, p < 0,001) and ICEBc (4,86 ± 0,86 vs. 4,21 ± 0,24, p < 0,001) were significantly higher in patients with aneurysmal SAH. QT, QTc and Tp-e interval, Tp-e/QTc ratio, ICEB (QT/QRS) and ICEBc (QTc/QRS) were positively correlated with the Fisher score and were negatively correlated with the GCS. According to linear regression analyses, the ICEBc (QTc/QRS) found to be independently associated with the Fisher score. Conclusion The values of the ICEB and ICEBc were significantly increased in patients with aneurysmal SAH. The severity of SAH was positively correlated with the ICEB and ICEBc. The ICEBc (QTc/QRS) independently associated with the Fisher score. This may that SAH suggest may predispose to malignant ventricular arrhythmias.

Effect of the index of cardiac electrophysiological balance on major adverse cardiovascular events in patients with diabetes complicated with coronary heart disease

“…The QTc interval was calculated using Bazett’s formula (QTc interval = QT interval ÷ square root of RR interval). The ICEB value was calculated using a non-invasive method described by Yücetas et al (2022) (ICEB = QT interval ÷ QRS duration).…”

Early Cardiac Evaluation, Abnormal Test Results, and Associations with Outcomes in Patients with Acute Brain Injury Admitted to a Neurocritical Care Unit

“…Shared mechanisms include neurogenic stress, neuroinflammation, and autonomic dysfunction [3,4]. While no prospective, multicenter clinical trials to date have examined the prevalence of cardiac abnormalities after ABI, in the last five years, small-sample, single-center clinical prospective and retrospective studies suggest that cardiac abnormalities such as elevated cardiac troponin, beta-natriuretic peptide, and prolonged QTc interval may be present after ABI and may be associated with poor outcomes [5][6][7][8][9][10][11][12].…”

Comparison Between Cardio-Electrophysiological Balance Index and Corrected Values in Different Age Groups Among School-Age Children

“…Adult studies have been conducted on using iCEB and iCEBc values in various diseases. Among these diseases, COVID-19, end-stage renal disease, sarcoidosis, type 1 diabetes mellitus, tinnitus, subarachnoid haemorrhage, type myotonic dystrophy can be enumerated (2)(3)(4)(5)(6)(7)(8)(9). However, studies revealing the ranges of average iCEB values in the pediatric age group are limited.…”