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Vinod Chaubey & Lovely Chhabra

Vinod Chaubey & Lovely Chhabra

University of Massachusetts Medical School, USA

Title: Electrocardiographic impacts of lung resection

Biography

Chhabra has authored and co-authored two book chapters in Cardiovascular Medicine and over 20 peer-reviewed journal publications of which 16 have been published in several International peer-reviewed scientifi c journals. He has presented his scholarly work at over 20 state, national and international medical society meetings. He has also served on the reviewer boards of several international peer-reviewed medical journals including American Journal of Cardiology, Indian Heart Journal, Hemodialysis International and Indian Pacing and Electrophysiology. His research interests include electrocardiography, pericardial diseases, interatrial conduction blocks and electrocardiographic changes associated with various pulmonary diseases. He is starting his Cardiovascular diseases fellowship training at the University of Connecticut (Hartford Hospital) in July, 2013 and is planning to actively continue his research activities during his future career.Chhabra has authored and co-authored two book chapters in Cardiovascular Medicine and over 20 peer-reviewed journal publications of which 16 have been published in several International peer-reviewed scientifi c journals. He has presented his scholarly work at over 20 state, national and international medical society meetings. He has also served on the reviewer boards of several international peer-reviewed medical journals including American Journal of Cardiology, Indian Heart Journal, Hemodialysis International and Indian Pacing and Electrophysiology. His research interests include electrocardiography, pericardial diseases, interatrial conduction blocks and electrocardiographic changes associated with various pulmonary diseases. He is starting his Cardiovascular diseases fellowship training at the University of Connecticut (Hartford Hospital) in July, 2013 and is planning to actively continue his research activities during his future career.

Abstract

Introduction: Electrocardiographic (ECG) changes accompanying lung resection have not been well investigated previously in a large controlled series of human adults. Th us, our current investigation was undertaken for a better understanding of the ECG changes associated with lung resection. Materials and Methods: Medical records of 117 patients who underwent lung resection (segmentectomy, lobectomy, or pneumonectomy) were reviewed. Th eir clinical course and ECG’s were compared during early, intermediate and late postoperative course (<1 month, 1 month to 1 year and >1 year post-op respectively). Results: Patients in the acute postoperative phase had higher heart rate, increased maximum P-duration and P-dispersion, increased incidence of atrial arrhythmias and frequent ST-T changes. P-vector and QRS-vector were signifi cantly aff ected aft er the lung resections; the correlation being most consistent between the anatomical displacements and the QRS-vector in the majority of patients. Th e frontal QRS vector displacements were statistically signifi cant aft er pneumonectomies and demonstrated a characteristic temporal relationship aft er left pneumonectomy (a left ward deviation in the acute, normal or slight rightward deviation in the intermediate and a rightward deviation in the late postoperative course) [p<0.0003]. Precordial R-wave transition was oft en delayed in patients with the left lung resections where the fi ndings simulated as an acute anteroseptal myocardial infarction; however the R/S transition oft en occurred early in the patients who underwent right sided lung resections [p<0.0001]. Conclusion: Th e understanding and recognition of the expected ECG fi ndings aft er lung resection is imperative to avoid confusing these changes with other acute cardiopulmonary events which would prevent unnecessary further investigational work-up. Th ese ECG changes are oft en dynamic and may bear a temporal relationship to the dynamic post-surgical changes in the thoracic anatomy.

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