Lung Lobectomy Affects Electrocardiographic Intervals
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概要
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After lung lobectomy, the residual thoracic cavity is filled by expansion of the remaining lobes and by mediastinal shifting. The mediastinal shift contributes to a change in the anatomical position of the heart. This change may affect electrocardiographic (ECG) findings but the relationship has not been examined. In this study, ECG intervals, including RR, P, PR, S-Tp, QRS, and QTc intervals, were analyzed before and after 86 lung lobectomies, consisting of 27 right upper (RU), 10 right middle (RM), 12 right lower (RL), 25 left upper (LU), and 12 left lower (LL) lobectomies. Persistent postoperative arrhythmia was observed in 10 patients (12%), all with atrial fibrillation. After RU lobectomies, the RR, PR, and S-Tp intervals became shorter. After RM lobectomies, the RR and QTc intervals became shorter and the P and PR intervals were prolonged. RL, LU, and LL lobectomies did not appreciably affect the ECG intervals. The post/pre-operative ratio of the P and PR intervals were greater following RM lobectomy than following RU or RL lobectomy. The post/pre-operative ratio of the QTc interval was smaller after RM lobectomy than after RL lobectomy. Lung lobectomy affected ECG intervals and the pattern of change varied depending on the lobe resected. Resection of the RM lobe, the lobe that is anatomically next to the right atrium, prolonged the PR interval and the change in pattern was different from RU or RL lobectomies. The change in the anatomical position of the heart following lung lobectomy may contribute to the changes in ECG intervals.
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