The Effect of Iron Replacement Therapy on Electrocardiographic Consequences in Pediatric Patients

Background Sudden cardiac death is an important problem, because the patients have no opportunity to receive medical service. Recently some electrocardiogram (ECG) parameters are used for predicting arrhythmias, including P wave duration for predicting atrial arrhythmias and corrected QT and T wave peak to end interval (Tp-e), for predicting ventricular arrhythmias. Iron deficiency is the most prevalent nutrient disorder worldwide in which iron loads in different tissues including myocardium are decreased. We aimed to investigate the relationship between iron deficiency and arrhythmogenic ECG parameters. Then we compared electrocardiographic parameters of iron deficient patients before and after iron replacement therapy. Materials and Methods In the first phase of study, ECG and blood samples were taken from 9-18 years old healthy adolescents for CBC and ferritin tests. They were divided into three groups according to serum ferritin: group 1 (ferritin below 15), group 2 (ferritin 15-30), and group 3 (ferritin above 30) ng/ml. In phase two, group 1 were given standard iron replacement therapy. We compared ECG parameters in three groups and then in group 1 before and after treatment. Results The number of individuals in three groups was 120 (group 1= 25, group 2= 26 and group 3= 69). The results showed that all parameters were significantly higher in group one and the lowest in group three. Also, there was a significant decrease in these parameters after treatment in group one (P<0.05). Conclusion Based on the results, Iron deficiency through decreased myocardial iron load can prolong ECG parameters and elevate risk of arrhythmia. Also, iron replacement therapy can reduce this risk.