Aisha Javed, Firasat Waqar, Shaista Ahmed, Attiya Sabeen Rahman, Qaiser Jamal, Tahir Hussain.
Different patterns of ECG in organophosphate poisoning and effect on mortality.
Pak Heart J Jan ;49(3):121-5.

Objective: To determine different patterns of ECG changes in Organophosphate Poisoning and mortality related to it. Methodology: We conducted an observational cross sectional study from 1st June 2015 to 31 Dec 2015 in the department of Medicine, Abbasi Shaheed Hospital, Karachi. Patients agreeing for informed consent following inclusion and exclusion criteria were consecutively included. All patients were above 13 year of age, of either gender with history of exposure to organophosphate compounds within previous 24 hours with characteristic manifestation of organophosphate poisoning. They were evaluated for cardiac status through electrocardiography(ECG) to observe the changes like heart rate, PR interval, ST-T changes, PVCs and QTc interval. The data was analyzed with SPSS 17. Results: Out of 79 patients 44(55.6%) were females. The mean age of the sample was 24.41 +/- 10.1 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 changes and PVCs were present in 4 (11.76%) patients. First degree block was least observed ECG finding which was present in 2 (5.88%) patients. Respiratory depression was found in 7 (8.86%) patients in which 6 were having prolonged QTc and only 1 had PVC. All these patients were put on ventilator but only 4 survived while the rest of the 3 (30.79%) died having prolonged QTc. Conclusion: ECG changes are frequently observed in patients with organophosphate poisoning. Pronged QTc interval is associated with respiratory depression and increased risk of mortality.

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