Electrocardiographic markers for the early detection of cardiac disease in patients with beta-thalassemia major

Objective: To comparatively evaluate P-wave dispersion (PWD) in patients with beta-thalassemia major (TM) and healthy control subjects for the early prediction of arrhythmia risk. Methods: Eighty-one children with beta-TM, aged 4-19 years, and 74 healthy children (control group) underwent routine electrocardiography and transthoracic echocardiography for cardiac evaluation. PWD was calculated as the difference between the maximum and the minimum P-wave duration. Results: There was a statistically significant difference between study and control groups in peak early (E) mitral inflow velocity and E/late (A) velocity ratio. Maximum P-wave duration and PWD were found to be significantly higher in beta-TM patients than in control subjects. Conclusions: Increased PWD in our beta-TM patients might be related to depression of intra-atrial conduction due to atrial dilatation and increased sympathetic activity. These patients should be closely followed up for risk of life-threatening arrhythmias.