Prolongation of the QTc interval during alcohol withdrawal syndrome.

BACKGROUND: Cardiac arrhythmias might explain cases of sudden death in alcoholics during ethanol abstinence.

AIM OF STUDY: To evaluate QT interval (and its outcome) in patients with alcohol withdrawal syndrome.

PATIENTS AND METHODS: Sixty-two patients (52 male and 10 female, mean age 43.7 years, range 18-71 years), admitted to the hospital as a result of alcohol abstinence syndrome (tremulousness in 7 cases, agitation in 12 cases, delirium tremens in 11 cases, and seizures in 32) were studied. The QT interval was measured on 12 lead ECGs performed on admission in all cases. QTc was obtained using Bazett's formula. In 27 patients a second ECG was performed during hospital stay. Results. Mean QTc interval on admission was 439 +/- 32 ms (range 350-525 ms); 29 patients (46.8%) showed a prolonged (> 440 ms) QTc interval. No significant differences were observed between patients with normal and high QTc values as regards to age, sex, type of withdrawal syndrome, duration of abstinence, liver function tests, serum electrolytes or blood cell counts. In cases where two ECG recordings could be evaluated (n = 27), the mean QTc interval was significantly shorter in the latter than in the former (417 +/- 26 ms versus 447 +/- 30 ms, respectively, p < 0.001). Eight patients found to have prolonged QTc on admission had a second ECG performed on them after complete recovery from withdrawal symptoms. In all these cases the QTc interval eventually became normal.

CONCLUSION: The QTc interval is frequently prolonged during alcohol withdrawal syndrome and tends to become normal over time, along with remission of abstinence symptoms.