Evaluation of the Changes in T Peak-T End Interval and T Peak-T End/QT Ratio in Tricyclic Antidepressant Intoxication

Year 2020, Volume: 2 Issue: 3, 57 - 63, 05.12.2020

Can Yıldız Ramazan Köylü , Yahya Kemal Günaydın , Belgin Akıllı , Göknur Yıldız , Özge Turgay Yıldırım

Abstract

Introduction
Tricyclic antidepressant (TCA) intoxication can affect various systems including cardiovascular system. In recent years, the transmiyocardial repolarization parameters including T peak-Tend (Tp-Te) interval, Tp-Te dispersion and Tp-Te/QT have been shown to be associated with increased cardiac arrhythmia risk. The aim of this study was to evaluate the effect of TCA intoxication on transmyocardial repolarization parameters.
Methods
This study was a cross-sectional study including 124 patients (43 male and 81 female) who were followed up and treated for TCA intoxication and 37 volunteer controls. At admission, 6th hour and 24th hour, the electrocardiogram of the patients were evaluated and Tp-Te and QT interval were measured manually and Tp-Te/QT ratio was calculated.
Results
The mean age of the study group was 27.95±7.72. There were statistically significant difference in terms of Tp-e (p<0.001), Tp-Te mean (p<0,05) and dispersion (p <0,05) in V2-6 derivations between patient and control groups. There were significant difference in the Tp-Te/QT values in V2-5 derivations (p<0,05). We found a statistically significant difference in maximum and minimum QT values (p<0,001), prolonged QTc, prolonged QTc dispersion and prolonged mean Tp-Te/QT values between patient and control groups (p <0.05); prolonged mean Tp-Te values were similar between groups (p = 0,117). In the ROC analysis performed to investigate the diagnostic value of Tp-Te and Tp-Te/QT data in predicting disease, we found that all leads except V2 derivation were diagnostic (p <0.05).
Conclusion
TCA intoxication significantly increased the transmiyocardial repolarization parameters compared to the healthy population.

Keywords

Tricyclic antidepressant intoxication, Tp-Te interval, QT interval, Tp-Te/QT ratio, electrocardiography

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