Hyperbaric oxygen therapy reduces the risk of QTc interval prolongation in patients with diabetes and hard-to-heal foot ulcers

J Diabetes Complications. Nov-Dec 2015;29(8):1198-202. doi: 10.1016/j.jdiacomp.2015.07.023. Epub 2015 Jul 29.

Abstract

Aims: Heart rate corrected QT (QTc) interval prolongation is a risk factor associated with increased mortality. Hyperbaric oxygen therapy (HBO) has previously been shown to have acute beneficial effects on QTc dispersion. The aim of this study was to evaluate long-term effects of HBO on QTc time in diabetic patients with hard-to-heal foot ulcers.

Methods: In a prospective, double-blinded placebo-controlled study, patients were randomized to 40 treatment sessions with either HBO or air (placebo), at 2.5 ATA. Patients fulfilling >35 completed treatment sessions were included in the evaluation.

Results: Of the initial 75 patients (38 HBO/37 placebo), two were excluded due to pacemaker use. Baseline characteristics were similar between groups. At the 2-year follow-up, QTc time was significantly shorter in the HBO compared to the placebo group (438 vs. 453ms, p<0.05). Further, fewer HBO treated patients had a QTc time >450ms (22 vs. 53 %, p<0.02). This difference seemed to be caused by a significant prolongation of the QTc interval in the placebo group (427 (419-459) at baseline vs. 456ms (424-469) after 2years), whereas no significant change was seen in HBO treated patients.

Conclusions: HBO treatment might protect against QTc prolongation in this high-risk diabetic population.

Keywords: Diabetes complications; Diabetes mellitus; Diabetic autonomic neuropathy; Foot ulcer; Hyperbaric oxygen therapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care
  • Ankle Brachial Index
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Cardiomyopathies / complications
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / prevention & control*
  • Diabetic Foot / complications
  • Diabetic Foot / physiopathology
  • Diabetic Foot / therapy*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperbaric Oxygenation*
  • Long QT Syndrome / complications
  • Long QT Syndrome / epidemiology
  • Long QT Syndrome / prevention & control*
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Sweden / epidemiology
  • Wound Healing