BACKGROUND: The development of hepatocellular carcinoma (HCC) is influenced by multiple factors. Interventional therapy offers an effective treatment option for patients with unresectable intermediate-to-advanced HCC. Interventional therapy can induce electrocardiographic (ECG) abnormalities that may be associated with liver dysfunction, electrolyte disorders, and cardiac injury. AIM: To explore the ECG alterations and determinants following interventional therapy in patients with HCC. METHODS: Sixty patients undergoing interventional treatment for liver cancer were selected as study participants. According to the results of the dynamic ECG examination 1 day after surgery, the patients were divided into an abnormal group ( RESULTS: The 24 hours QT interval variability, 24 hours normal atrial polarization to ventricular polarization (R-R) interval (standard deviation), 24 hours consecutive 5 minutes normal R-R interval, and 24 hours continuous 5 minutes normal R-R interval (standard deviation mean) were lower than patients in the nonabnormal group ( CONCLUSION: Interventional therapy for HCC can lead to ECG abnormalities, underscoring the clinical need for enhanced cardiac monitoring to mitigate myocardial complications.