Search

Background: Post-operative changes in electrocardiography (ECG) after lung surgery have been investigated in prior researches. We have limited data about benign physiologic changes in ECG after lung surgery, specifically after lung resection. The aim of our study was to investigate relationship in between lung resection with minimally invasive robotic or video-assisted thoracoscopic surgery (VATS) and its effect on ECG after lung resection., Methods: After exclusion criteria had been applied, a total of 133 patients were enrolled in the present study. Operational information such as amount of resected segment and side of resection was recorded. Lung resections were divided into two groups. One group included surgeries with lung resections <3 segments and other group included surgeries with segmentectomy ≥3 segments. Pre-operative and postoperative (in between 2nd and 3rd months) ECG data of the patients were compared. The location of resected segments as left-sided and right-sided resections were noted to compare the ECG changes for sub-analysis., Results: Among 133 patients, 101 patients were male (75.9%). There was no significant difference between parameters including ventricular rate, P wave, QRS wave and T wave axis in degrees, PR, QRS, QT and QTc durations, Tpe interval, ratio of Tpe interval to QT and QTc interval and fQRSTa. There was significant difference between before and after resection in terms of degree of QRS axis (before resection =37.3 ± 52.7 vs. after resection = 26.2 ± 55.7, P = .026). Sub-analysis regarding to amount of resected segments, there was no significant difference identified in terms of QRS axis in degrees between before and after resection for patients who underwent lung resection <3 segments (p = .885). However, there was significant difference in QRS axis in degrees for patients who underwent lung resection ≥3 segments (before resection = 47.3 ± 57.5 vs. after resection = 23.7 ± 66.2, P = .010). There was significant rightward axial change after left-sided lung resections (before resection =32.0 ± 52.4 vs. after resection = 49.4 ± 47.1, P = .005) and leftward axial change after right-sided lung resection (before resection = 41.7 ± 53.0 vs. after resection = 7.1 ± 55.2, P < .001)., Conclusion: Understanding and recognition of possible ECG changes are crucial during post-operative follow-up of the patients who underwent lung resection. These changes might be benign changes, which are related to anatomical and geometrical changes within thoracic cavity., Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Macromastia is associated with symptoms related to postural changes and decreased mobility. Breast reduction surgery (BRS) is the treatment of choice for these patients. Anatomical and structural changes in body posture and habitus might cause changes in electrocardiography (ECG). In this study, we aimed to evaluate the outcome of BRS on ECG changes of the patients after surgery. Study population included 33 female patients who had undergone BRS. ECG records of every patient before procedure and 6 months after procedure were analyzed retrospectively. Patients were naïve of known cardiac diseases and the patients did not have any known arrhythmia. The mean age of the study population was 40.8 ± 9.6. Total removed breast tissue from both sides was 1493 (1052–2138) mL, as 800 (513–1093) mL removed from right side and 740 (519–1050) mL removed from left side. There were significant changes in ECG of the patients in post-operative period. Atrial conduction parameters such as, PR duration (p<.001), Pmax duration (p<.001) and P wave dispersion (p<.001) were significantly decreased post-operatively. Additionally, ventricular conduction parameters such as, TPe duration (p<.001), TPe/QT (p=.013) and TPe/QTc (p=.005) ratios were found significantly decreased in ECGs of the patients. BRS as a treatment for macromastia does not only improve posture and mobility of the patients and also have positive impact on cardiac conductions. In patients those had BRS, atrial and ventricular conductions detected by ECG recordings were improved after surgery. [ABSTRACT FROM AUTHOR]

Introduction: The new definition of periprocedural myocardial infarction (type 4a MI) excludes patients without angina and electrocardiographic or echocardiographic changes suggestive of myocardial ischemia even though significant serum troponin elevations occur following percutaneous coronary intervention (PCI). Aim: To evaluate the incidence and predictors of serum troponin rise following elective PCI in patients without clinical and procedural signs suggestive of myocardial necrosis by using a high-sensitivite troponin assay (hsTnT). Material and methods: Three hundred and four patients (mean age: 60.8 ±8.8 years, 204 male) undergoing elective PCI were enrolled. Patients with periprocedural angina, electrocardiographic or echocardiographic signs indicating myocardial ischemia or a visible procedural complication such as dissection or side branch occlusion were excluded. Mild-moderate periprocedural myocardial injury (PMI) and severe PMI were defined as post-PCI (12 h later) elevation of serum hsTnT concentrations to the range of 14-70 ng/l and > 70 ng/l, respectively. Results: The median pre-procedural hsTnT level was 9.7 ng/l (interquartile range: 7.1-12.2 ng/l). Serum hsTnT concentration elevated (p < 0.001) to 19.4 ng/l (IQR: 12.0-38.8 ng/l) 12 h after PCI. Mild-moderate PMI and severe PMI were detected in 49.3% and 12.2% of patients, respectively. Post-procedural hsTnT levels were significantly higher in multivessel PCI, overlapping stenting, predilatation and postdilatation subgroups. In addition, post-procedural hsTnT levels were correlated (r = 0.340; p < 0.001) with the stent lengths. Conclusions: High-sensitivite troponin measurements indicate a high incidence of PMI even though no clinical or procedural signs suggestive of myocardial ischemia exist. Multivessel PCI, overlapping stenting, predilatation, postdilatation and longer stent length are associated with PMI following elective PCI. [ABSTRACT FROM AUTHOR]