QTc Interval Prolongation and Hemorrhagic Stroke: Any Difference Between Acute Spontaneous Intracerebral Hemorrhage and Acute Non-traumatic Subarachnoid Hemorrhage?

BACKGROUND: A variety of ECG changes occur as an aftermath of stroke. Prolongation of the QTc interval is a well-documented change. We analyzed QTc interval prolongation among patients with acute hemorrhagic strokes.

METHODS: This observational study was conducted at the Emergency Department of Sulaymaniyah General Teaching Hospital and Shar Hospital from September 1st , 2014 to August 31st , 2015. Fifty patients who developed acute spontaneous hypertensive intracerebral hemorrhage (ICH) and 50 patients who developed acute non-traumatic subarachnoid hemorrhage (SAH) were included in the study. All patients underwent resting 12-lead ECG within half an hour of admission. The QTc interval was calculated and analyzed in those 100 patients.

RESULTS: Females (62%) outnumbered males (38%) with a female to male ratio of 1.6:1. Forty percent of the patients were between 60-69 years of age. Hypertension was seen in 82% of patients while left ventricular hypertrophy was documented in 40% of patients. The QTc was prolonged in 38 patients (17 patients in the ICH group and 21 patients in the SAH group). In both groups, males demonstrated QTc prolongation more than females. However, there were no statistically significant gender difference between both groups and within the same group. There was a statistically significant association between SAH and QTc prolongation (p-value<0.001); the ICH group did not demonstrate any significant relationship with QTc prolongation.

CONCLUSION: Prolongation in the QTc interval was "statistically" associated with acute SAH only. No gender difference was noted; whether this observation is clinically significant or not, it needs further analytic studies.