Index of cardiac electrophysiological balance can better predict the risk of arrhythmia than QT and Tp-e interval in patients inhalating sevoflurane

Abstract

Abstract Objective: To compare the value of ECG markers such as QT interval, Tp-e interval and index of cardiac electrophysiological balance (iCEB) in evaluating the effect of sevoflurane on cardiac electrophysiology. Methods: Sixty patients undergoing elective gynecological surgery were randomly divided into group S1, group S2 and group S3, 20 cases in each group. Patients were received 10ml/kg of hydroxyethyl starch, 0.1mg/kg of midazolam, 0.1 mg/kg of vecuronium, 3μg/kg of fentanyl and 0.3mg/kg of etomidate intravenously. Mechanical ventilation was performed after endotracheal intubation. Sevoflurane concentration was maintained at 0.6 MAC, 1.3 MAC and 2.0 MAC in group S1, group S2 and group S3 respectively. The QT interval, QRS interval and Tp-e interval were measured before anesthesia induction (T1), 5 minutes after tracheal intubation (T2), and 20 minutes after rising to the set concentration of sevoflurane (T3). The QTc interval, Tp-e/QT ratio and iCEB were measured and calculated. MAP and HR were recorded at the same time. Results Compared with T1-2, MAP and HR decreased at T3 in S1-3 group (P < 0.05); Compared with T1, iCEB increased at T2-3 in S1-3 groups, QTc interval prolonged at T3 in S1-3 groups (P < 0.05). Compared with T2, iCEB increased at T3 in S1-3 groups. Compared with S1 group , the Tp-e Shortened, iCEB increased in S2-3 groups . Compared with S2 group, iCEB decreased in S3 group at T3. Conclusion: iCEB is more sensitive and objective, and can better predict the risk of arrhythmia. iCEB can be used as the preferred index to evaluate the electrophysiological effects by anesthetics in clinic.