Amna Faruqi, Sofia Amjad, Ahmed Nurus Sami, Sobia Hassan, Quratul-ain Zia.
Electrocardiographic Changes in Thalassemia Major Patients and their Association with Serum Ferritin Levels.
J Rawal Med Coll Jan ;19(3):185-8.

Background: To evaluate the use of electrocardiography (ECG) in thalassemia major patients, for the early detection of iron overload induced cardiac complications. Methods: Serum ferritin analysis and a standard 12 lead ECG was performed on 135 thalassemia major patients. SPSS Version 20 was used for data analysis. For categorical variables, frequencies and percentages were calculated. For quantitative variables, mean with standard deviation was calculated. Chi Square test was used for finding association between different ECG changes and serum ferritin levels. A p value of <0.05 was considered to be statistically significant. Results: Patients ranged in age from 7-30 years. Males constituted 51 %. The mean serum ferritin level was 6062.61 + 3641.796 ng/ml. There was no significant difference between the mean ferritin levels in males and females (p =0.366) One or more abnormal electrocardiographic findings were observed in 88.1% of patients. The most commonly observed findings were flattening of the T wave, followed by arrthymias, tachycardia, pathological T wave inversions, long QT interval, left ventricular hypertrophy (LVH) and right ventricular hypertrophy (RVH). Long QT interval was the only abnormality found to be significantly associated with high ferritin levels. (p =0.001). Conclusion: ECG can be used for monitoring thalassaemia major patients for the development of cardiac complications, especially where magnetic resonance imaging (MRI) is not available.

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