The Predictive Value Of The First Postoperative Body Surface Electrocardiogram For The Postoperative Effect Of Cardiac Resynchronization Therapy

Objective: The first postoperative ecg V1 lead R/S ratio and I lead R/S ratio were analyzed to predict the outcome of cardiac resynchronization therapy.Methods: A retrospective study was conducted on 103 patients with cardiac insufficiency who underwent crt-d(42 cases)and crt-p(61 cases)implantation in the union hospital affiliated to huazhong university of science and technology from 2008 to 2018.According to the results of cardiac ultrasound ejection fraction reexamination after surgery,the patients were divided into the CRT hyperreaction group(42 cases)and the CRT non-hyperreaction group(61 cases).The data of cardiac resynchronization(baseline data)and postoperative reexamination(ecg,echocardiography,etc.)were retrospectively analyzed.Cardiac color doppler ultrasound left ventricular ejection fraction(LVEF)was increased by 5% compared with that before surgery,and LVEF 40%,which was divided into the hyperreaction group,and vice versa.After cardiac resynchronization treatment,the first body surface electrocardiogram,R/S ratio of lead I 1 or R/S ratio of lead V1 1 was defined as positive R/S ratio,then negative R/S ratio was defined as negative.Results: 1.Baseline data: the left ventricular end-diastolic volume(LVEDD)in the hyperreaction group was lower than that in the non-hyperreaction group(P <0.05),and the left ventricular ejection fraction(LVEF)was higher than that in the non-hyperreaction group(P <0.05).2.Review data: PR interval,QRS duration and LVEDD of the postoperative hyperreaction group were significantly improved compared with those of the preoperative group(P <0.05).In the hyperreaction group,31 patients(78.3%)with positive S/R ratio of the first postoperative ecg were in the hyperreaction group.In the non-hyperreaction group,57.4% of the patients with positive R/S ratio of the first ecg were in the hyperreaction group,while only 22.4% of the patients with positive R/S ratio were in the non-hyperreaction group(P <0.05).3.Analysis of the prediction of various reasons for cardiac resynchronization treatment results: the positive R/S ratio of the first postoperative body surface ecg was an independent predictor(OR=1.00,95%ci =0.98-1.01,P < 0.01).Conclusion: R/S ratio 1 or V1 lead R/S ratio 1 for the first time after cardiac resynchronization treatment was defined as positive R/S ratio indicating prognosis hyperresponsiveness,which can be used as a practical method to predict surgical hyperresponsiveness.