Effect of hunger strike on electrocardiographic parameters

OBJECTIVE
This study is a comparison of the electrocardiogram (ECG) findings of detainees and convicts who participated in a hunger strike recorded at the end of the strike and 2 months later.

METHODS
A total of 81 male detainees and convicts (mean age 41±9.4 years) who participated in a hunger strike between September 2012 and November 2012 were included in this study. The mean duration of the fast was 45±9.6 days. Measurements of blood pressure, body weight, and serum electrolytes (sodium, potassium, calcium) obtained on the last day of the hunger strike and 2 months later were compared, as well as 12-lead ECG readings obtained at the same intervals, which were scanned and transferred to a high-resolution electronic format and evaluated.

RESULTS
The mean weight loss for the 81 patients during the hunger strike was 6±3.7 kg. Early repolarization (ER) (inferior: 10, lateral: 5, inferolateral: 1) was detected in 16 (19.7%) ECGs taken on the last day of fasting, and in 4 (4.9%) (inferior: 3, lateral: 1) of those measured 2 months after the strike (p<0.001). A significant difference was observed in the PR interval (157±75 ms vs. 153±23 ms; p=0.035) and QRS duration (95±73 vs. 92±11; p=0.001), whereas there was no significant difference in heart rate (p=0.068). Additionally, there was no significant difference in terms of electrolyte levels between the last day of the hunger strike and 2 months after its conclusion.

CONCLUSION
This is the first time long-term lack of nutrition was demonstrated to be associated with ER.