24 H ELECTROCARDIOGRAPHIC MONITORING IN MORBIDLY OBESE PATIENTS DURING SHORT-TERM ZERO CALORIE DIET

The medical literature of the previous decades has reported sudden une xpected death among cases of very low calorie dieters. Cardiac arrhyth mias, possibly produced by a prolonged QT interval, were suspected to be the main cause of death in a considerable number of these cases. Th e aim of this study was to investigate the occurrence of significant c ardiac arrhythmias and prolongation of the QT interval, during short-t erm zero calorie diet, in morbidly obese patients. A group of 11 such patients (BMI > 35 kg/M2) were treated with a short-term zero calorie diet, as in-patients for ten days, followed by an out-patient regime o n an 800 kcal diet. Their ages ranged from 19-58 years (mean 43.6). No ne had diabetes mellitus, cardiac, liver or renal disease, or thyroid or pituitary abnormalities, and none took any medication except Allupu rinol 300 mg/day. We used a 24 h holter monitoring system to detect ca rdiac arrhythmias or prolonged QT interval. Recordings were performed on the day before starting the fast, while the patients were on their regular diet, and compared with similar recordings of the same patient s taken on the 10th day of the fast. No significant cardiac arrhythmia s or prolongation of the QT interval were recorded during the fasting period. Short-term zero calorie dieting provided the patients with phy sical and psychological encouragement and is a safe method for reducin g weight if it is carried out under strict medical supervision.