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Elective lung resection increases spatial QRS-T angle and QTc interval.

Szymon Bialka1, Andrzej Jaroszynski2, Todd T Schlegel3

  • 1Department of Anaesthesiology and Intensive Therapy, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.

Cardiology Journal
|December 22, 2018
PubMed
Summary

Lung resection significantly alters electrocardiographic measurements, widening the spatial QRS-T angle and prolonging the corrected QT interval, particularly after left pneumonectomy. These changes were more pronounced in patients who developed atrial fibrillation post-surgery.

Keywords:
atrial fibrillationcorrected QT intervalgeneral anaesthesiaspatial QRS-T anglevectorcardiography

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Electrocardiography

Background:

  • Lung resection alters intrathoracic anatomy, potentially impacting electrocardiographic results.
  • Postoperative cardiac arrhythmias are known after lung resection, but vectorcardiographic changes remain undocumented.
  • This study investigates changes in spatial QRS-T angle and corrected QT interval following lung resection.

Purpose of the Study:

  • To analyze changes in spatial QRS-T angle (spQRS-T) and corrected QT interval (QTc) after lung resection.
  • To determine if lung resection impacts these specific vectorcardiographic parameters.
  • To compare changes across different types of lung resection procedures.

Main Methods:

  • Seventy-one adult patients undergoing elective lung resection were studied.
  • Patients were grouped by surgical procedure: left lobectomy (LL), left pneumonectomy (LP), right lobectomy (RL), and right pneumonectomy (RP).
  • spQRS-T angle and QTc interval were measured pre-surgery and at 24, 48, and 72 hours post-surgery.

Main Results:

  • Lung resection significantly increased spQRS-T (p < 0.001) and QTc (p < 0.05) in the overall study group.
  • The most substantial changes in spQRS-T and QTc were observed in patients who underwent left pneumonectomy (LP).
  • Postoperative atrial fibrillation (AF) occurred in 6.4% of patients, associated with wider spQRS-T angles and longer QTc intervals.

Conclusions:

  • Lung resection leads to widening of the spQRS-T angle and prolongation of the QTc interval, especially after left pneumonectomy.
  • While postoperative AF is infrequent, it correlates with significant alterations in spQRS-T and QTc.
  • These findings highlight the impact of lung resection on cardiac electrical activity.