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Published on: November 28, 2018
Electrocardiography is Useful to Predict Postoperative Ventricular Arrhythmia in Patients Undergoing Cardiac Surgery:
Weichao Li1, Weihua Liu1, Heng Li1
1The Sixth Affiliated Hospital of Guangzhou Medical University, Department of Anesthesiology, Qingyuan People's Hospital, QingYuan, China.
Insights
Preoperative electrocardiographic (ECG) markers, including J wave, Tpeak-Tend interval (Tpe) over 112.5 ms, and SV1+RV5 over 35 mm, can predict postoperative ventricular arrhythmia (POVA) in cardiac surgery patients. A new risk model utilizes these ECG findings for improved POVA prediction.
Area of Science:
- Cardiology
- Medical Diagnostics
- Biomarkers
Background:
- Postoperative Ventricular Arrhythmia (POVA) poses a significant risk after cardiac surgery.
- Noninvasive methods for preoperative risk stratification of POVA are crucial for patient management.
- Electrocardiographic (ECG) markers offer a potential noninvasive approach to assess POVA risk.
Purpose of the Study:
- To evaluate the predictive value of preoperative ECG markers for identifying patients at high risk of POVA.
- To develop and validate a novel risk prediction model for POVA using ECG parameters.
- To enhance clinical decision-making for cardiac surgery patients through improved POVA risk assessment.
Main Methods:
- Retrospective analysis of 823 cardiac surgery patients.
- Logistic regression to identify significant preoperative ECG predictors of POVA.
- Development and ROC curve validation of a new risk prediction model for POVA.
Main Results:
- A preoperative J wave, Tpe >112.5 ms, and SV1+RV5 >35 mm were independently associated with increased POVA risk.
- These ECG markers demonstrated significant predictive power in multivariate analysis.
- The developed risk prediction model showed efficacy in predicting POVA occurrence.
Conclusions:
- Specific preoperative ECG biomarkers (J wave, Tpe, SV1+RV5) are valuable predictors of POVA.
- A novel ECG-based risk prediction model can effectively stratify patients for POVA risk preoperatively.
- These findings support the integration of ECG analysis into preoperative risk assessment for cardiac surgery.
Abstract:
Background: Preoperative detection of high-/low-risk postoperative ventricular arrhythmia (POVA) patients using a noninvasive method is an important issue in the clinical setting. This study mainly aimed to determine the usefulness of several preoperative electrocardiographic (ECG) markers in the risk assessment of POVA with cardiac surgery. Method: We enrolled 1024 consecutive patients undergoing cardiac surgery, and a total of 823 patients were included in the study. Logistic regression analysis determined preoperative ECG markers. A new risk predicting model were developed to predict occurrence of POVA, and the receiver operating characteristic curve (ROC) was used to validate this model. Results: Of these, 337 patients experienced POVA, and 485 patients did not experience POVA in this retrospective study. Among 15 ECG markers, a univariate analysis found a strong association between POVA and preoperative VA, the R-wave in lead aVR, the QRS wave, index of cardiac electrophysiological balance (iCEB), QT interval corrected (QTc), Tpeak-Tend interval (Tpe) in lead V2, the J wave in the inferolateral leads, pathological Q wave, and SV1+RV5>35 mm. Multivariate analysis showed that a preoperative J wave [adjusted odds ratio (AOR): 3.80; 95% CI: 1.88-7.66; p < 0.001], Tpe >112.5-ms (AOR: 2.80; 95% CI: 1.57-4.99; p < 0.001), and SV1+RV5 >35 mm (AOR: 2.92; 95% CI: 1.29-6.60; p = 0.01) were independently associated with POVA. A new risk predicting model were developed in predicting POVA. Conclusion: The ECG biomarkers including J wave, Tpe >112.5 ms, and SV1+RV5 >35 mm were significantly predicted POVAs. A risk predicting model developed with electrocardiographic risk markers preoperatively predicted POVAs.
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