evaluation of the correlation between electrocardiographic abnormalities, cardiac iron overload, and magnetic resonance t2* values in patients with beta thalassemia major

Background: beta thalassemia major (β-tm) is an inherited blood disorder. affected patients require frequent blood transfusions, leading to iron deposition and end organ damage, particularly myocardial dysfunction. a 12-lead ecg is a readily available tool that could be used to screen for conduction abnormalities and arrhythmias as a marker of worsening myocardial function. methods: a total of 108 β-tm patients were evaluated for correlation between abnormal findings on the surface ecg and severity of myocardial iron deposition in magnetic resonance imaging as measured by t2* levels. results: patients with t2* below 20 msec had significantly longer pr intervals, p wave durations, and qtc intervals. patients with t2* below 10 msec had the longest qrs duration and qrs activation times. atrial fibrillation was more prevalent in patients with lower t2* levels. with a decrease in t2*, the probability of notching of qrs in the limb and precordial leads increased. conclusion: abnormal ecg is prevalent in β-tm patients, and the frequency of changes increases with the severity of iron overload. a 12-lead ecg is a valuable and readily available tool for the early assessment of myocardial damage and the implementation of a timely and appropriate management strategy.