ASSESSING THE FREQUENCY OF ELECTROCARDIOGRAPHIC (ECG) CHANGES AMONG PATIENTS RECEIVING INTRAMUSCULAR MEGLUMINE ANTIMONIATE FOR THE TREATMENT OF CUTANEOUS LEISHMANIASIS

Abstract

Background: Cutaneous leishmaniasis (CL) is a neglected tropical disease endemic in Pakistan and several other low- and middle-income countries. Meglumine antimoniate, a pentavalent antimonial compound, remains the most widely used first-line treatment for CL. Despite its therapeutic efficacy, the drug is known to cause cardiotoxic effects, particularly electrocardiographic (ECG) abnormalities, which may remain subclinical but could progress to life-threatening arrhythmias. Monitoring ECG changes during therapy is essential to mitigate potential cardiac risks.

Objective: To evaluate the frequency and types of ECG changes in patients receiving intramuscular meglumine antimoniate for the treatment of cutaneous leishmaniasis and to assess associations with demographic and clinical variables.

Methods: This descriptive study was conducted over three months in the Dermatology Ward of Combined Military Hospital, Peshawar. A total of 78 patients, aged 18–75 years with confirmed CL, were enrolled using non-probability consecutive sampling. Patients with known cardiac disease, chronic systemic illness, or pregnancy were excluded. Baseline and 2-week post-treatment 12-lead ECGs were obtained and analyzed by a consultant cardiologist. Data were processed using SPSS version 23. ECG parameters including heart rate, PR interval, and QT interval were compared pre- and post-treatment. Chi-square and Mann-Whitney U tests were used for inferential analysis with p ≤ 0.05 considered statistically significant.

Results: Out of 78 patients, 28 (35.8%) exhibited ECG changes following treatment. The most common abnormalities were QT interval prolongation in 10 patients (12.8%), tachycardia in 7 (8.9%), PR interval prolongation in 6 (7.7%), and ST-T wave abnormalities in 5 (6.4%). A significant association was observed between age above 50 years and ECG abnormalities (p = 0.03).

Conclusion: Intramuscular meglumine antimoniate is associated with subclinical but potentially serious ECG changes in a significant proportion of patients. Regular ECG monitoring is advised during therapy, particularly in older adults, to minimize cardiac risks.