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Evaluation of Electrocardiographic Parameters and the Presence of Interatrial Block in Patients with Mad Honey Intoxication

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Abstract

Mad honey intoxication (MHI) is a food-induced clinical condition that usually presents with cardiovascular symptoms and can lead to life-threatening arrhythmias if not diagnosed and treated early. No data exist in the literature on the presence of interatrial block (IAB) after food intoxication. In our study, we sought to investigate atrioventricular electrocardiography (ECG) parameters and determine the frequency of IAB in patients with MHI. In total, 76 patients diagnosed with MHI were included in our retrospective study. Twelve-lead ECGs were performed and participants were divided into two groups according to the presence of IAB in the reference ECG. The P maximum (Pmax), P minimum (Pmin), P dispersion (Pdisp), T peak to T end (Tp–Te) interval and QT dispersion (QTdisp) values were compared between the two groups. IAB was detected in 28 (35.5%) of 76 MHI patients included in the final analysis. Pmax duration (122 ± 8; p < 0.001) and PD (69 ± 11; p < 0.001) were significantly higher in the IAB ( +) group. During regression analysis, Pmax [odds ratio (OR) 1.158, 95% confidence interval (CI) 1.036–1.294; p = 0.010] and Pd (OR 1.086, 95% CI 1.001–1.017; p = 0.046) were independently associated with IAB. Pmax and Pd area under the receiver operating characteristic curve values for IAB prediction were 0.926 (95% CI 0.841–1,000; p < 0.001) and 0.872 (95% CI 0.765–0.974; p < 0.001), respectively. ECG changes are common in patients presenting with MHI. These patients need to be followed up clinically in terms of progression to arrhythmic events that may occur in the future.

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    Authors and Affiliations

    1. Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Tibbiye street, No:13, Haydarpasa, Istanbul, Turkey

      Altuğ Ösken & Kazım Serhan Özcan

    2. Department of Cardiology, Trabzon Vakfıkebir State Hospital, Trabzon, Turkey

      Ercan Aydın

    3. Department of Internal Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey

      Selçuk Yaylacı

    4. Department of Internal Medicine, Fındıklı State Hospital, Rize, Turkey

      Selçuk Yaylacı

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    1. Altuğ Ösken
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    2. Ercan Aydın
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    4. Selçuk Yaylacı
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    All authors contributed to (1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and, (3) final approval of the version to be published.

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    Correspondence to Altuğ Ösken.

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    Ösken, A., Aydın, E., Özcan, K.S. et al. Evaluation of Electrocardiographic Parameters and the Presence of Interatrial Block in Patients with Mad Honey Intoxication. Cardiovasc Toxicol 21, 772–780 (2021). https://doi.org/10.1007/s12012-021-09668-9

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