Features of the electrocardiogram with continuous-flow left ventricular assist devices
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摘要: 目的:探讨晚期充血性心力衰竭 (CHF) 患者植入左心室辅助装置 (LVAD) 后的心电图变化。方法:根据以下6个标准 (肢体导联低电压、心室起搏、伪影、QRS时限>120ms、侧璧导联ST段抬高以及QRS波群的分裂) 比较67例患者在心脏移植Ⅱ期LVAD植入前后的心电图的变化。另外, 随机选择40个"侧壁心肌梗死 (MI) "的非LVAD患者心电图和40个"心室起搏"的心电图进行评分。使用F检验精确计算优势比。建立Logistic回归模型对所有患者的LVAD进行预测。结果:植入LVAD前后的心电图单变量分析显示, 除了"QRS时限>120ms"之外的所有特点均符合LVAD患者的心电图。伪影和肢体导联低电压与LVAD患者的心电图关联最大。结论:LVAD装置植入后, CHF患者的心电图显著改变。LVADS2标准提供了一个用于连续性LVAD的患者的心电图特征分析和建立新基线的框架。
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关键词:
- 左心室辅助装置 /
- 连续性左心室辅助装置 /
- 心电图
Abstract: Objective: To study the electrocardiogram changes of LVAD patients in patients with congestive heart failure (CHF).Method: According to the following six criteria (low voltage of limb lead, ventricular pacing, artifact, QRS time limit>120 ms, ST segment elevation of the side lead and split of QRS wave group), we compared the changes of electrocardiogram (ECG) before and after II stage LVAD implantation in 67 patients.In addition, the ECG of 40 non LVAD patients with lateral myocardial infarction (MI) and the ECG of 40 ventricular pacing were randomly selected.The F test was used to accurately calculate the dominance ratio.Logistic regression model was established to predict the LVAD of all patients.Result: The electrocardiogram univariate analysis before and after LVAD implantation showed that all the characteristics except QRS time limit>120 ms were consistent with ECG of LVAD patients.Artifact and limb lead low voltage were most associated with ECG in LVAD patients.Conclusion: Electrocardiogram of CHF patients is significantly changed after implantation of LVAD device.The LVADS2 standard provides a framework for analyzing ECG characteristics and establishing a new baseline for patients with continuous LVAD. -
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