Emergency department decompensated heart failure treatments patients monitored QT interval on electrocardiography range prospective evaluation of change

Introduction: Heart failure is a major cause of mortality and morbidityworldwide. Emergency department visits due to heart failure symptoms are on therise.Objective: The objective of this study was to assess the prognostic value of QTinterval in patients? ECGs for evaluating decompensated heart failure patients anduse of this parameter to predict admittance or discharge criteria.Material and Method: This was a prospective, observational study. Data wascollected at Gazi University Hospital Adult Emergency Department, from January1st to March 31st, 2010.A total of 90 patients with heart failure were captured during the studyperiod. Based on the NYHA Functional Classification System, 12 of thesepatients were classified as Stage II, 39 patients as Stage III and 39 patients asStage IV. Only the Stage III and Stage IV patients were included in the study. Ofthe total of 78 patients in Stage III and IV 39 patients were determined to be usingmedications that might alter the QT interval, have a left bundle branch block,paced rhythm or elevated potassium levels and therefore were excluded from thestudy. Statistical analyses were performed on the remaining 39 patients.Results: The average pre-treatment QT interval of the patients was measured as486.28±44.06 milliseconds. The post-treatment QT interval measurementaveraged 432.31±43.34 milliseconds. Statistically significant differences werenoted between the pre-treatment and post-treatment QTc values (p<0.05 paired ttest).Conclusion: Statistically significant differences were found between the pretreatmentand post-treatment QTc values of the systolic heart failure patients whopresent in the emergency departments complaining of shortness of breath. Thismethod may be used by the emergency physicians as an adjunct to other testswhen evaluating the heart failure patients and determining the need for admissionor discharge.Key Words: Heart failure, ECG, QT interval, QTc value, ECHO