Seyedeh-Tarlan Mirzohreh
1* 
, Fariba Heidari
2 1 Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with metabolic disturbances, including insulin resistance and an increased risk of cardiovascular complications. This systematic review and meta-analysis, conducted following PRISMA guidelines, compared cardiac electrical activity in PCOS patients versus healthy controls. Databases (PubMed, Scopus, Web of Science, Cochrane) were searched using Joanna Briggs Institute (JBI) appraisal tools. Sixteen studies met inclusion criteria, with data categorized into atrial (P-wave) and ventricular (QT interval) electrical activity. Meta-analysis using RevMan and Comprehensive Meta-Analysis software revealed significant differences in atrial conduction. PCOS patients exhibited prolonged Pmax (mean difference=7.49; 95% CI [0.36, 14.63], P=0.04) and increased P dispersion (MD=10.74; 95% CI [5.96, 15.51], P<0.0001) compared to controls, while Pmin was shorter (MD=-2.23; 95% CI [-4.38, -0.08], P=0.04). For ventricular activity, only QTc interval was significantly shorter in PCOS patients (MD=-21.62; 95% CI [-37.70, -5.54], P=0.008), with no other QT abnormalities detected. These findings suggest that PCOS is associated with delayed atrial conduction, potentially increasing susceptibility to atrial arrhythmias, while ventricular repolarization remains largely unaffected. The study highlights a possible cardiac electrophysiological alteration in PCOS, emphasizing the need for closer cardiovascular monitoring in these patients. Further research should explore the long-term implications of these ECG changes on arrhythmia risk and cardiovascular outcomes in PCOS.