Cardiac arrhythmias and electrophysiologic responses during spontaneous hyperglycaemia in adults with type 1 diabetes mellitus - 02/11/21
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Highlights |
• | Spontaneous hyperglycaemia didn’t prolong QTc interval in people with T1DM and without history of cardiovascular disease. |
• | Cardiac arrhythmias were uncommon and confined to bradycardia and ectopic beats. |
• | There was considerable diurnal and inter-subject variability in the incidences of arrhythmias. |
• | Reassuringly, hyperglycaemia wasn’t linked with clinically relevant arrhythmias. |
Abstract |
Aim |
We examined the effect of spontaneous hyperglycaemia in adults with type 1 diabetes mellitus (T1DM) and without history of cardiovascular disease on heart rate variability (HRV), cardiac repolarisation and incidence of cardiac arrhythmias.
Methods |
Thirty-seven individuals with T1DM (age 17–50 years, 19 males, mean duration of diabetes 19.3 SD(9.6) years) underwent 96 h of simultaneous ambulatory 12-lead Holter ECG and blinded continuous interstitial glucose (IG) monitoring (CGM). HRV, QT interval and cardiac repolarisation were assessed during hyperglycaemia (IG ≥ 15 mmol/l) and compared with matched euglycaemia (IG 5−10 mmol/l) on a different day, separately during the day and night. Rates of arrhythmias were assessed by calculating incidence rate differences.
Results |
Simultaneous ECG and CGM data were recorded for 2395 hours. During daytime hyperglycaemia vs euglycaemia the mean QTc interval duration was 404 SD(21)ms vs 407 SD(20)ms, P = 0.263. T-peak to T-end interval duration corrected for heart rate (TpTendc) shortened: 74.8 SD(16.1)ms vs 79.0 SD(14.8)ms, P = 0.033 and T-wave symmetry increased: 1.62 SD(0.33) vs 1.50 SD(0.39), P = 0.02. During night-time hyperglycaemia vs euglycaemia, the mean QTc interval duration was 401 SD(26)ms vs 404 SD(27)ms, P = 0.13 and TpTend shortened: 62.4 SD(12.0)ms vs 67.1 SD(11.8)ms, P = 0.003. The number of cardiac arrhythmias was low and confined to bradycardia and isolated ectopic beats. A considerable inter-subject and diurnal variability was observed.
Conclusions |
Hyperglycaemia in individuals with T1DM without known cardiovascular disease was not associated with clinically important cardiac arrhythmias.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Cardiac arrhythmias, Cardiac electrophysiology, Heart rate variability (HRV), Hyperglycaemia, QTc interval, Type 1 diabetes mellitus (T1DM)
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Vol 47 - N° 5
Articolo 101237- settembre 2021 Ritorno al numero
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