Change of corrected QT dispersion before and after stone removal by therapeutic endoscopic retrograde cholangiopancreatography and its influencing factors
Received:February 18, 2019  
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DOI:10.11915/j.issn.1671-5403.2019.06.083
Key words:arrhythmia; endoscopic retrograde cholangiopancreatography; corrected QT dispersion
Author NameAffiliationE-mail
LI Feng Department of Cardiology,Nanjing 210011, China  
ZHU Yong-Xiang Department of Cardiology,Nanjing 210011, China  
WANG Fei Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China  
WU Xiao-Chao Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China  
MIAO Lin Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China  
LONG Ming-Zhi Department of Cardiology,Nanjing 210011, China longmzh@hotmail.com 
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Abstract:
      Objective To investigate the change of corrected QT dispersion (QTcd) before and after stone removal by therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and the related influencing factors. Methods A total of 61 patients who underwent therapeutic ERCP for stone removal in our hospital from June 2018 to January 2019 were consecutively enrolled as subjects. Resting 12-lead electrocardiography (ECG) was performed before and in 3h and 24h after operation. The patients with QTcd in 3h after operation higher than the value before were assigned into QTcd-increased group, otherwise were into QTcd-reduced group. Statistical analysis was performed using SPSS 23.0. Student t test or Chi-square test was used for comparison between groups on different data types. Multivariate logistic regression analysis was applied to screen the risk factors of QTcd increase at 3h post-ERCP. Results Among the 61 patients, 1 of them experienced ventricular fibrillation immediately after ERCP, and so complete data were obtained from the left 60 patients. The average QTcd value was (29.05±11.09), (36.00±13.46) and (21.81±10.52)ms respectively, before and at 3h and 24h post-ERCP. The value at 3h after ERCP was significantly higher than those at the other 2 time points (P<0.05). Multivariate logistic regression analysis showed that female (OR=15.895,5%CI 2.505-100.853) and estimated glomerular filtration rate (eGFR, OR=1.039,5%CI 1.003-1.077) were the risk factors for QTcd increase at 3h post-ERCP. Conclusion Therapeutic ERCP can lead to QTcd increase in a short time (3h) after stone removal by ERCP, which suggesting increased risk for malignant arrhythmia at that duration. Female and eGFR are the risk factors for QTcd increase at 3h post-ERCP.
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