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Increased QT and P-wave dispersion during attack-free period in pediatric patients with migraine attacks

Published online by Cambridge University Press:  17 April 2019

Oyku Tosun Open the ORCID record for Oyku Tosun [Opens in a new window]  and
Elif Karatoprak
Oyku Tosun*
Affiliation:
Department of Pediatric Cardiology, Medeniyet University Faculty of Medicine, Istanbul, Turkey
Elif Karatoprak
Affiliation:
Department of Pediatric Neurology, Medeniyet University Faculty of Medicine, Istanbul, Turkey
*
Author for correspondence: Oyku Tosun, Department of Pediatric Cardiology, Medeniyet University Faculty of Medicine, Istanbul, Turkey. Tel: +905053901685; Fax: +902165666614; E-mail: [email protected]
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Abstract

Introduction:

Migraine is a common neurovascular disease characterised with recurrent attacks by pain-free periods. It has been suggested that both sympathetic and parasympathetic dysfunctions play a role in its pathophysiology.

Aim:

The aim of our study was to investigate the ECG changes during attack-free period in children with migraine, in terms of QTc interval, QTc, and P-wave dispersion to evaluate the autonomic nervous system disturbance.

Methods:

Sixty children who were diagnosed with migraine were included as patient group and 50 healthy, age- and body mass index-matched children who were examined for innocent murmur were included as control group. The patients’ routine ECG records were screened from the outpatient clinic files. The durations of P-wave, QT, and QTc intervals and dispersion values and heart rates (beats/minute) were compared between the patient and control groups.

Results:

P maximum and P dispersion were significantly higher, and P minimum was significantly lower in the migraine group compared with the control group. QT–QTc maximum and QT–QTc dispersion were significantly higher and QT–QTc minimum was significantly lower in the migraine group compared with the control group.

Conclusion:

According to our findings, although migraine patients were asymptomatic and no arrhythmia was detected in the surface ECG, sympathovagal balance in the sympathetic system, which may be disrupted in favour of the sympathetic system, should continue even in the attack-free period, and we should be careful in terms of serious arrhythmias that may develop in these patients.

Keywords

Autonomic nervous systemelectrocardiographymigrainepediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 4 , April 2019 , pp. 488 - 491
Copyright
© Cambridge University Press 2019 

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Footnotes

*

The study is a single-centre original retrospective article.

References

Lipton, RB, Bigal, ME. Migraine: epidemiology, impact and risk factors for progression. Headache 2005; 45: 3–13.CrossRefGoogle ScholarPubMed
Havanka-Kanniainen, H, Tolunen, U, Myllyla, VV. Autonomic dysfunction in migraine: a survey of 188 patients. Headache 1988; 28: 465–470.CrossRefGoogle ScholarPubMed
Koçer, A, Eryılmaz, M, Tutkan, H, Ercan, N, Küçükbayrak, ZS. Higher P-wave dispersion in migraine patients with higher number of attacks. Sci World J 2012; 2012: 791460.CrossRefGoogle ScholarPubMed
Bellavere, F, Ferri, M, Guarini, L, et al. Prolonged QT period in diabetic autonomic neuropathy: a possible role in sudden cardiac death? Br Heart J 1998; 59: 379–383.CrossRefGoogle Scholar
Yılıdırır, A, Aksoyek, S, Calguneri, M, et al. QT dispersion as a predictor of arrhythmic events in patients with ankylosing spondylitis. Rheumatology 2000; 39: 875–879.CrossRefGoogle Scholar
Galinier, M, Vıalette, JC, Fourcade, J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure. Importance of aetiology. Eur Heart J 1998; 19: 1054–1062.CrossRefGoogle ScholarPubMed
Barr, CS, Naas, A, Freeman, M, Lang, CC, Struthers, AD. QT dispersion and sudden unexcepted death in chronic heart failure. Lancet 1994; 343: 327–329.CrossRefGoogle Scholar
Zabel, M, Klingenheben, T, Franz, MR, Hohnloser, SH. Assessment of OT dispersion for prediction of mortality or arrhytmic events after myocardial infarction: results of prospective, long-termfollow-up study. Circulation 1998; 97: 254–350.CrossRefGoogle Scholar
Dilaveris, PE, Gialafos, EJ, Sidesis, S, et al. Simple electrocardiographic markers for prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998; 135: 773–778.CrossRefGoogle ScholarPubMed
Dilaveris, PE, Gialafos, EJ, Andrikopoulos, GK, et al. Clinical and electrocardiographic predictors of recurrent atrial fibrillation. Pacing Clin Electrophysiol 2000; 23: 352–358.CrossRefGoogle ScholarPubMed
Jhee, SS, Salazar, DE, Ford, NF, et al. Monitoring of acute migraine attacks: placebo response and safety data. Headache 1998; 38: 35–38.CrossRefGoogle ScholarPubMed
Duru, M, Melek, I, Seyfeli, E. Q Tc dispersion and P-wave dispersion during migraine attacks. Cephalalgia 2006; 26: 672–677.CrossRefGoogle Scholar
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 629–808.CrossRefGoogle Scholar
Aygun, D, Altıntop, L, Doganay, Z, Guven, H, Baydın, A. Electrocardiographic changes during migraine attacks. Headache 2003; 43: 861–866.CrossRefGoogle ScholarPubMed
Appel, S, Kuritzky, A, Zahavi, I, Zigelman, M, Akselrod, S. Evidence for instability of the autonomic nervous system in patients with migraine. Headache 1992; 32: 10–17.CrossRefGoogle ScholarPubMed
Diedrich, J, Jordan, JR, Shannon, D, et al. Modulation of QT interval during autonomic nervous system blockade in humans. Circulation 2002; 106: 2238–2243.CrossRefGoogle ScholarPubMed
Dilaveris, E, Gialafos, JE. P wave dispersion: a novel predictor of paroxysmal atrial fibrillation. Ann Noninvasive Electrocardiol 2001; 6: 159–165.CrossRefGoogle ScholarPubMed