Durmuş Gündüz, Kalyoncuoğlu Muhsin, Karataş Mehmet Baran, Çanga Yiğit, Öztürk Semi, Özal Ender, Çakıllı Yasin, Kırış Tuncay, Güngör Barış, Alper Ahmet Taha, Can Mehmet Mustafa, Bolca Osman
Department of Cardiology, Haseki Training and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2017 Jul;45(5):408-414. doi: 10.5543/tkda.2017.59084.
Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment for urinary tract calculi. While serious side effects are rare, transient cardiac arrhythmias may occur. New electrocardiographic (ECG) parameters, such as P wave dispersion (PWD), QT dispersion (QTd), T peak to T end (Tp-e) interval, Tp-e interval/QT ratio, and Tp-e interval/corrected QT ratio have been defined to help predict atrial and ventricular arrhythmias. However, effect of ESWL on these ECG parameters has not been previously investigated. The present study was an examination of the effect of ESWL on ECG parameters.
Total of 40 consecutive patients who underwent ESWL were prospectively enrolled in the study. Pre-procedure ECG parameters were compared with post-procedure ECG parameters.
PWD values were significantly longer on post-procedure ECG compared with pre-procedure ECG (p=0.017). Corrected QT duration and QTd were significantly longer on postprocedure ECG compared with pre-procedure ECG (p=0.046 and p=0.008, respectively). In addition, Tp-e interval, Tp-e interval/QT ratio, and Tp-e interval/QTc ratio were significantly longer post procedure (p=0.035, p=0.045, and p=0.022, respectively). In univariate correlation analysis, duration of procedure was significantly correlated with post-procedure PWD, QTc, and QTD values.
Clinical use of ECG parameters may be helpful in monitoring of patients receiving ungated ESWL in order to detect cardiac dysrhythmia.
体外冲击波碎石术（ESWL）是治疗尿路结石的一种安全有效的方法。虽然严重副作用罕见，但可能会出现短暂性心律失常。新的心电图（ECG）参数，如P波离散度（PWD）、QT离散度（QTd）、T峰至T末（Tp-e）间期、Tp-e间期/QT比值以及Tp-e间期/校正QT比值已被定义，以帮助预测房性和室性心律失常。然而，此前尚未研究ESWL对这些ECG参数的影响。本研究旨在探讨ESWL对ECG参数的影响。
本研究前瞻性纳入了40例连续接受ESWL治疗的患者。比较术前和术后的ECG参数。
与术前ECG相比，术后ECG的PWD值显著延长（p = 0.017）。与术前ECG相比，术后ECG的校正QT间期和QTd显著延长（分别为p = 0.046和p = 0.008）。此外，术后Tp-e间期、Tp-e间期/QT比值和Tp-e间期/QTc比值也显著延长（分别为p = 0.035、p = 0.045和p = 0.022）。在单因素相关性分析中，手术时间与术后PWD、QTc和QTD值显著相关。
ECG参数的临床应用可能有助于监测接受非门控ESWL治疗的患者，以便检测心律失常。
