What does this research mean for the field?

Patients with schizophrenia exhibit significantly higher frequencies of proarrhythmic and ischemic electrocardiographic abnormalities, including pathological Q-waves, fragmented QRS, and increased QT and P-wave dispersion, compared to healthy individuals. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2022Open Access

Pathological Q Wave in Electrocardiographic Examinations of Patients with Schizophrenia

Structured PICO

Do hospitalized patients with schizophrenia have a higher frequency of proarrhythmic and ischemic ECG changes compared to healthy controls?

Population

324 subjects, comprising 190 hospitalized patients with schizophrenia and 134 healthy controls. Exclusions: systemic cardiac disease, rheumatic heart disease, pre-excitation syndrome, heart failure, permanent pacemaker, and anti-arrhythmic drug use.

Comparator

134 healthy control subjects

Outcome

Frequency of ischemic and proarrhythmic electrocardiographic (ECG) changes (including heart rate, P-wave dispersion, QT dispersion, fragmented QRS, and pathological Q-wave)surrogate

Hospitalized patients with schizophrenia exhibit significantly more proarrhythmic and ischemic ECG changes, including fragmented QRS and pathological Q-waves, which may contribute to their higher risk of premature cardiovascular death.

Abstract

Aim: The aim of our study was to investigate the frequency of the ischemic and proarrhythmic electrocardiographic (ECG) changes in schizophrenia patients compared to normal healthy population. Methods: This study was planned retrospectively. ECG documents were obtained from the first day of admission to patients' psychiatric clinic. The study involved 190 hospitalized schizophrenia patients and 134 healthy controls. The rhythm of the patient, presence of channelopathy, hypertrophy findings of cardiac cavities, conduction defects, ischemic changes, p-wave length, p-wave dispersion (PWD), the presence of fragmented QRS (fQRS), QT dispersion were considered in the ECG records. Results: The mean systolic and diastolic blood pressure were higher in the control group (p<0.001). Smoking was more prevalent among patients with schizophrenia. The heart rate was higher in the schizophrenia group than control group (85.5 vs 70.5 beats/min;p<0.001). QT-dispersion time was also higher in the schizophrenia group (35 milliseconds versus 55 milliseconds; p<0.001). P-wave dispersion time was found higher in schizophrenia group (30 to 47.50 milliseconds, p<0.001). The incidence of fragmented QRS (fQRS) was 36.30% (n: 69) in the schizophrenic group and 7.5% (n:10) in the healthy control group (p=0.001). Pathological Q-wave frequency was about 10 times higher in patients with schizophrenia (p<0,001). Conclusions: The proarrhythmic and ischemic electrocardiographic changes may explain the high frequency of premature deaths seen in patients with schizophrenia. When psychiatrists evaluate schizophrenia patients, they should be aware of these cardiac findings and should be in close contact with cardiologists as necessary.

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