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Turk Kardiyol Dern Ars. 2019 Jul;47(5):379-383. doi: 10.5543/tkda.2018.57794.

Effect of hunger strike on electrocardiographic parameters.

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Department of Cardiology, Karatay University Faculty of Medicine, İstanbul, Turkey.
Department of Cardiology, Silivri Prison State Hospital, İstanbul, Turkey.
Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.



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.


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.


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.


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

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