A study on QT dispersion and thrombolytic therapy in acute myocardial infarction

Background: Myocardial infarction is a major manifestation of ischemic heart disease, a leading cause of death in developed nations and the third globally. QTc dispersion is an important marker of ventricular repolarization variations and arrhythmogenic risk. This study examines the effects of thrombolytic therapy on QTc dispersion in acute myocardial infarction
Materials and methods: 88 patients admitted to Al Ameen Medical College Hospital, Vijayapur, for acute MI were included in the study. Over a period of 8±2 days, all patients underwent monitoring, with standard 12-lead ECGs conducted upon admission and before discharge. QT interval, QTc interval, and QT and QTc dispersion parameters were calculated from these ECGs.
Results: Analysis revealed significant variations in QT parameters between patients treated and not treated with thrombolytic therapy. Patients receiving thrombolytic therapy exhibited greater reductions in QT parameters by day 8±2 compared to those without treatment. Additionally, anterior wall infarctions demonstrated significantly higher QT and QTc dispersions compared to inferior wall infarctions, with these differences being statistically significant.
Conclusion: In the early stages of acute myocardial infarction, patients, especially those diagnosed with anterior myocardial infarction, exhibited significantly elevated QT and QTc dispersions. Thrombolytic treatment resulted in substantial reductions in these dispersions compared to untreated individuals. Typically peaking within the initial hours of the condition, these dispersions subsequently decline following successful thrombolysis, underscoring their significance in risk assessment for malignant ventricular tachyarrhythmias and reinforcing the efficacy of thrombolytic therapy