• Farman J. Ahmed Department of Cardiology, Sulaimani Teaching Hospital, Interventional Cardiology Center, Kurdistan Region, Iraq.
  • Aram J. Mirza Sulaimaniyah Teaching Hospital, Mistry of Health, Kurdistan Region, Iraq.
  • Hemn H. Mohammad Department of Cardiology, Sulaimani Teaching Hospital, Interventional Cardiology Center, Kurdistan Region, Iraq.
  • Amar Talib Al-Hamdi Sulaimani, Kurdistan Region, Iraq.



Measurement of QRS, QTc Duration, Dispersion Predicts Ventricular Arrhythmias, Acute Myocardial Infraction



Myocardial infarction is one of the most common causes of mortality in middle and older age groups, especially in the presence of a ventricular arrhythmia.


To determine the relationship between QRS and QTc duration and dispersion with the occurrence of ventriculricular arrhythmia in early stage of myocardial infarction.


This prospective study of 100 patients (72 males) admitted to Slemani Cardiac Hospital, Sulaimani, Kurdistan Region -Iraq with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Electrocardiograms on admission and one day later were evaluated for the duration and dispersion of corrected QT interval (QTc) and QRS.


Mean QTc was 453±35 ms on admission and 440±31.3 ms one day later. Mean QTc dispersion (QTC) was 69±18.4 ms on admission and 49.8±15 ms one day later. Mean QRS duration was 76.8±12.8 ms on admission and 70±10.7 ms one day later, while mean QRS dispersion (d QRS) was 29.4±14.7 ms on admission and 18.8±17.5 ms one day later. There was a significant correlation between ventricular arrhythmia and QRS, dQRS, QTc, and dQTc ≥ 60ms.


Patients with the increased value of corrected QT dispersion, QRS duration, and dispersion in the early stage of STEMI have a greater likelihood of developing ventricular arrhythmia.


Engelstein ED, Zipes DP. Sudden cardiac death. In: Hurst WJ, (Ed.), Hurst's the heart, arteries, and veins. 9th Edition, McGraw Hill, USA. 1998, 1081-1112

Wright RS, Anderson JL, Adams CD, Bridges CR, Casey DE, Ettinger SM, et al. 2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients with Unstable Angina/Non–ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2011 May 10;57(19):e215-e367. DOI:

Newby KH, Thompson T, Stebbins A, Topol EJ, Califf RM, Natale A. Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO Investigators. Circulation 1998; 8;98(23):2567-73. DOI:

Bezzina CR, Pazoki R, Bardai A, Marsman RF, de Jong JS, Blom MT, et al. Genome-wide association study identifies a susceptibility locus at 21q21 for ventricular fibrillation in acute myocardial infarction. Nat Genet 2010;42(8):688-91. DOI:

Janse MJ, Wit AL. Electrophysiological mechanisms of ventricular arrhythmias resulting from myocardial ischemia and infarction. Physiol Rev 1989;69(4):1049-69. DOI:

Holmes DR Jr, Berger PB, Hochman JS, Granger CB, Thompson TD, Califf RM, et al. Cardiogenic Shock in patients with ischemic syndromes with and without ST-segment elevation. Circulation 1999;100(20):2067-73. DOI:

Odemuyiwa O, Malik M, Farrell T, Bashir Y, Poloniecki J, Camm J. Comparison of the predictive characteristics of heart rate variability index and left ventricular ejection fraction for all-cause mortality, arrhythmic events and sudden death after acute myocardial infarction. Am J Cardiol 991;68(5):434-9. DOI:

Pogwizd SM, Corr PB. Mechanisms underlying the development of ventricular fibrillation during early myocardial ischemia. Circ Res 1990;66(3):672-695. DOI:

Chávez-González E, Rodríguez Jiménez AE, Moreno-Martínez FL.QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infarction. Med Intensiva 2017;41(6): 347-55. DOI:

Gadaleta FL, Llois SC, Sinisi VA, Quiles J, Avanzas P, Kaski JC et al. Prolongación del intervalo QT corregido: nuevo predictor de riesgo cardiovascular en el síndrome coronario agudo sin elevación del ST. Rev Esp Cardiol 2008;61(6):572-8. DOI:

Roguin, A (Mar 2011). "Henry Cuthbert Bazett (1885–1950)—the man behind the QT interval correction formula". Pacing Clin Electrophysiol. 34 (3): 384–8 DOI:

Gatzoulis MA, Till JA, Somerville J, Redington AN. Mechanoelectrical interaction in tetralogy of Fallot. QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation1995;92(2):231-237. doi:10.1161/01.Cir.92.2.231 DOI:

Adeyi, Olusoji; Smith, Owen; Robles, Sylvia. 2007. Public Policy and the Challenge of Chronic Noncommunicable Diseases. Directions in Development; Human Development. Washington, DC: World Bank. © World Bank. License: CC BY 3.0 IGO.” DOI:

Life tables for the WHO Member States. Geneva, World Health Organization, 2009 ( life_tables/life_tables.cfm). pp. 1–149

Rahimi K, Watzlawek S, Thiele H, Secknus M-A, Hayerizadeh B-F, Niebauer J, Schuler G et al. Incidence, time course, and predictors of early malignant ventricular arrhythmias after non-ST-segment elevation myocardial infarction in patients with early invasive treatment. European Heart Journal 2006;27:1706–1711 DOI:

Hetland M, Haugaa K, Sarvari SI, Erikssen G, Kongsgaard E, Edvardsen T, et al. A novel ECG-index for prediction of ventricular arrhythmias in patients after myocardial infarction. Ann Noninvasive Electrocardiol 2014;19(4):330-7.

Jie X, Trayanova NA. Mechanisms for initiation of reentry in acute regional ischemia phase 1B. Heart Rhythm 2010;7(3):379-86. DOI:

Ma N, Cheng H, Lu M, Jiang S, Yin G, Zhao S et al. Cardiac magnetic resonance imaging in arrhythmogenic right ventricular cardiomyopathy: correlation to the QRS dispersion. Magn Reson Imaging 2012;30(10):1454-60. DOI:

Rodríguez-Sinovas A, Cinca J. Isquemia miocárdica y arritmias ventriculares en modelos experimentales: mecanismos desencadenantes. Rev Esp Cardiol. 1999;52(10):851-9. DOI:

Sheng QH, Hsu CC, Li JP, Hong T, Huo Y. Correlation between fragmented QRS and the short-term prognosis of patients with acute myocardial infarction. J Zhejiang Univ Sci B 2014;15(1):67-74. DOI:

Bayés de Luna A, Elosua R. Muerte súbita. Rev Esp Cardiol 2012;65(11):1039-52. DOI:

Hetland M, Haugaa K, Sarvari SI, Erikssen G, Kongsgaard E, Edvardsen T, et al. A novel ECG-index for prediction of ventricular arrhythmias in patients after myocardial infarction. Ann Noninvasive Electrocardiol 2014;19:330-7. DOI:

Kirchhof P, Eckardt L, Arslan O, Reinhardt L, Mönnig G, Fetsch T, Breithardt G, Borggrefe M, Haverkamp W et al. Prolonged QRS duration increases QT dispersion but does not relate to arrhythmias in survivors of acute myocardial infarction. Pacing Clin Electrophysiol 2001;24(5):789-95. DOI:

Perkiömäki JS, Koistinen MJ, Yli-Mäyry S, Huikuri H V. Dispersion of QT interval in patients with and without susceptibility to ventricular tachyarrhythmias after previous myocardial infarction. J Am Coll Cardiol1995;26(1):174-9. DOI:

Zaputović L, Mavrić Z, Zaninović-Jurjević T, Matana A, Bradić N. Relationship between QT dispersion and the incidence of early ventricular arrhythmias in patients with acute myocardial infarction. Int J Cardiol 1997;62:211-216 DOI:

Paventi S, Bevilacqua U, Parafati MA, Di Luzio E, Rossi F, Pelliccioni PR et al. QT dispersion and early arrhythmic risk during acute myocardial infarction. Angiology 1999;50(3):209-15 DOI:

Leitch J, Basta M, Dobson A. QT dispersion does not predict early ventricular fibrillation after acute myocardial infarction. Pacing Clin Electrophysiol. 1995 Jan;18(1 Pt 1):45-8. doi: 10.1111/j.1540-8159.1995.tb02474.x. PMID: 7700830. DOI:

Fiol M, Marrugat J, Bergada J, Guindo J, Bayes de Luna A. QT dispersion and ventricular fibrillation in acute myocardial infarction. Lancet 1995;346 (8987):1424 DOI:

Higham PD, Furniss SS, Campbell RW. QT dispersion and a component of QT interval in ischemia and infarction. Br Heart J 1995;73(1):32-36 DOI:

Higham PD, Campbell RWF. QT dispersion. Br Heart J 1994;71(6):508–510 DOI:

Aziz F, Doddi S, Alok A, Penupolu S, Singh V, Benz M, Abed M et al. QT dispersion as a predictor for arrhythmias in patients with acute ST-elevation myocardial infarction. J Thorac Dis 2010;2(2):86-8. PMID: 22263025; PMCID: PMC3256448.

Mehta RH , Starr AZ , Lopes RD, Hochman JS, Widimsky P, Pieper.KS et al. . APEX AMI Investigators. Incidence of and outcomes associated with ventricular tachycardia or fibrillation in patients undergoing primary percutaneous coronary intervention. JAMA2009;301:1779–89 DOI:

Piccini JP , Berger JS, Brown DL. Early sustained ventricular arrhythmias complicating acute myocardial infarction. Am J Med2008;121:797–804. DOI:

Belén Álvarez-Álvarez, Noelia Bouzas-Cruz, Emad Abu-Assi, Sergio Raposeiras-Roubin, Andrea López-López, María Cristina González Cambeiro, Carlos Peña-Gil, José María García-Acuña, José Ramón González-Juanatey et al, Impact of Acute Coronary Syndrome Complicated by Ventricular Fibrillation on Long-term Incidence of Sudden Cardiac Death, Cardiología,2015: Vol. 68. Issue 10.pages 878-884 DOI:

Katia Orvin, Alon Eisen, Ilan Goldenberg, Shmuel Gottlieb, Ran Kornowski, Shlomi Matetzky, Gregory Golovchiner, Jairo Kuznietz, Natalie Gavrielov-Yusim, Amit Segev, Boris Strasberg, Moti Haim, et al, Outcome of contemporary acute coronary syndrome complicated by ventricular tachyarrhythmias, EP Europace, Volume 18, Issue 2, February 2016, Pages 219–226. DOI:



How to Cite


Similar Articles

1-10 of 119

You may also start an advanced similarity search for this article.