Department of Orthopedics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China (mainland).
Department of Electrocardiogram, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China (mainland).
Med Sci Monit. 2021 Mar 12;27:e928637. doi: 10.12659/MSM.928637.
BACKGROUND Concerns have been raised among clinicians and patients about the cardiovascular risks of bisphosphonates used in the treatment of osteoporosis. The goal of this study was to investigate the acute effect of zoledronic acid (ZA) infusion on arrhythmia development using an electrocardiograph (ECG). MATERIAL AND METHODS This prospective study was a self-controlled case series study that recruited 116 female patients with osteoporosis. The patients underwent standard 12-lead electrocardiography before and 1 day after zoledronic acid intravenous infusion to evaluate cardiac adverse effects and the change in ECG parameters after the infusion. Heart rhythm, atrial and ventricular premature contractions, atrial fibrillation, P wave, and QTc parameters were measured using an ECG. A blood biochemical examination was performed for all patients before the ZA infusion. Body temperature was measured twice per day. RESULTS Before ZA administration, ECG findings were normal in 47 patients and abnormal in 69 patients. After ZA administration, ECG findings were normal in 35 patients and abnormal in 81 patients. New onsets of premature atrial contractions and atrial fibrillation were observed in 1 patient each, and new onsets of premature ventricular contractions were observed in 2 patients. The heart rate was obviously higher, and the QT interval was obviously shorter after ZA administration, compared with before administration. No significant differences in P wave and QTc parameters were found between the 2 ECG measurements. CONCLUSIONS During the acute phase, 116 women with osteoporosis who were treated with zoledronic acid infusion did not develop significantly abnormal ECG changes.
临床医生和患者对骨质疏松症治疗中使用的双膦酸盐的心血管风险表示担忧。本研究的目的是使用心电图（ECG）研究唑来膦酸（ZA）输注对心律失常发展的急性影响。
这是一项前瞻性自身对照病例系列研究，共纳入 116 名女性骨质疏松症患者。患者在静脉注射唑来膦酸前后进行标准 12 导联心电图检查，以评估心脏不良反应和输注后心电图参数的变化。使用心电图测量心律、房性和室性早搏、心房颤动、P 波和 QTc 参数。所有患者在 ZA 输注前进行血液生化检查。每天测量两次体温。
ZA 给药前，47 例心电图正常，69 例心电图异常。ZA 给药后，35 例心电图正常，81 例心电图异常。各有 1 例出现房性早搏和心房颤动新发，2 例出现室性早搏新发。与给药前相比，给药后心率明显升高，QT 间期明显缩短。两次心电图测量的 P 波和 QTc 参数无显著差异。
在急性阶段，接受唑来膦酸输注治疗的 116 名骨质疏松症女性并未出现明显异常的心电图变化。
