Increased QT interval variability index in acute alcohol withdrawalDrug and Alcohol Dependence
Article in press 9 March 2007
Karl-Jürgen Bära , Email: Karl-Juergen.Baer@med.uni-jena.de
Michael Karl Boettgerb,
Mandy Koschkea,
Silke Boettgera,
Marei Grotelüschena,
Andreas Vossc and
Vikram K. Yeraganid, e
aDepartment of Psychiatry, Friedrich-Schiller-University, Jena, Germany
bInstitute of Physiology I, Friedrich-Schiller-University, Jena, Germany
cDepartment of Medical Engineering, University of Applied Sciences, Jena, Germany
dDepartment of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, USA
eDepartment of Psychiatry, University of Alberta, Edmonton, Canada
Received 13 September 2006; revised 14 January 2007; accepted 17 January 2007. Available online 9 March 2007.
Abstract
Objective
Acute alcohol withdrawal is associated with increased cardiovascular mortality, most likely due to cardiac arrhythmias. As the QT interval reflects the most critical phase for the generation of reentry and thus for arrhythmia, we examined QT variability in patients suffering from acute alcohol withdrawal.
Methods
High resolution electrocardiographic recordings were performed in 18 male unmedicated patients suffering from acute alcohol withdrawal, 18 matched controls and 15 abstained alcoholics. From these, parameters of beat-to-beat heart rate and QT variability such as approximate entropy and QT variability index (QTvi) were calculated. Measures were correlated with the severity of withdrawal symptoms and with serum electrolyte concentrations.
Results
Heart rate and QTvi were significantly increased in acute alcohol withdrawal. Abstained alcoholics did not significantly differ from controls. While QTvi correlated with the severity of alcohol withdrawal symptoms, the mean QT interval duration showed an inverse relationship with serum potassium concentrations.
Conclusion
Our data indicate increased QT variability and thus increased repolarization lability in acute alcohol withdrawal. This might add to the elevated risk for serious cardiac arrhythmias. In part, these changes might be related to increased cardiac sympathetic activity or low potassium, thus suggesting the latter as possible targets for adjuvant pharmacological therapy during withdrawal.
