DIFFERENT PATTERNS OF ECG IN ORGANOPHOSPHATE POISONING AND EFFECT ON MORTALITY

Abstract

Objective: To determine different patterns of ECG changes in OrganophosphatePoisoning and mortality related to it.

Methodology: We conducted an observational cross sectional study from 1June 2015 to 31 Dec 2015 in the department of Medicine, Abbasi ShaheedHospital, Karachi. Patients agreeing for informed consent following inclusion andexclusion criteria were consecutively included. All patients were above 13 yearsof age, of either gender with history of exposure to organophosphate compoundswithin previous 24 hours with characteristic manifestation of organophosphatepoisoning. They were evaluated for cardiac status through electrocardiography(ECG) to observe the changes like heart rate, PR interval, ST-T changes, PVCsand QTc interval. The data was analyzed with SPSS 17.

Results: Out of 79 patients 44(55.6%) were females. The mean age of the samplewas 24.41±stst10.1 years. About 59 (74.68%) patients intended to commit suicide,whereas 20 (25.3%) patients were exposed to organophosphate due to accident.ECG was abnormal in 34 (43.03%) patients. Sinus bradycardia was present in 10(29.41%) patients followed by sinus tachycardia which was present in 8(23.52%) patients. Prolonged QTc was present in 6 (17.64%) and ST-T changesand PVCs were present in 4 (11.76%) patients. First degree block was leastobserved ECG finding which was present in 2 (5.88%) patients. Respiratorydepression was found in 7 (8.86%) patients in which 6 were having prolongedQTc and only 1 had PVC. All these patients were put on ventilator but only 4survived while the rest of the 3 (30.79%) died having prolonged QTc.

Conclusion: ECG changes are frequently observed in patients withorganophosphate poisoning. Pronged QTc interval is associated with respiratorydepression and increased risk of mortality.