The effect of upper endoscopic procedures under sedation on ventricular repolarization: retrospective study

Background: Over the past twenty-five years, endoscopic procedures have played a substantial role in diagnosing and treating gastrointestinal system diseases. This study aimed to analyze the impact of balanced propofol sedation on myocardial repolarization parameters during endoscopy. Methods: Our study comprised 58 patients who underwent elective upper endoscopic (UE) procedures. A 12-lead electrocardiography was conducted on all patients at various time points, including before the procedure, after sedation, during the first and fifth minutes of UE, and post-procedure. Calculations of the QT interval, corrected QT (QTc) interval, Tpeak-Tend (Tp-e) interval, Tp-e/QT and Tp-e/QTc were performed using the 12-lead electrocardiograms. Results: Among 58 patients (46.6% female and 53.4% male) who underwent elective endoscopy, a statistically significant prolongation of QRS and Tp-e/QT intervals was observed after administration of sedation, during the endoscopy procedure and post-procedure in comparison to the pre-procedure measurements (p1 = 0.018, p2 = 0.005, p3 = 0.003, p4 = 0.007 and p1 < 0.001, p2 < 0.001, p3 < 0.001, p4 = 0.017 respectively). A marked reduction in the Tp-e/QTc ratio was observed following sedation, throughout the endoscopy procedure, and in the post-procedure phase, relative to the pre-procedure baseline (p1 < 0.001, p2 < 0.001, p3 < 0.001, p4 < 0.001). Conclusions: The findings of this study indicate that propofol sedation with a balanced approach resulted in a significant prolongation of QRS, QT and Tp-e/QT duration, along with a decrease in the Tp-e/QTc ratio. The impact of such sedation on ventricular repolarization necessitates acknowledgment and calls for caution regarding potential arrhythmias.

Balanced propofol sedation; Endoscopy; Electrocardiography; Tp-e interval; QT interval; Tp-e/QT ratio

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