A Study On Correlation Between FQRS And Ventricular Tachycardia

Objective: By collecting the medical histories and examination data of the patients who have been diagnosed definitively as persistent ventricular tachycardia(hereinafter referred to as VT),this research studies the possible correlation between the fragmented QRS complex,(f QRS)in electrocardiogram and the VT after its recovery to sinus rhythm,and tries to predict the VT with relevant clinical data.Method: Sample 308 patients with organic heart diseases who had persistent VT and relatively complete clinical data from the Second Hospital of Jilin University from Jan,2010 to Oct,2017.1.Collect medical histories including: 1)age,2)sex,3)smoking history,4)diabetes history,5)the history of cerebrovascular disease,6)history of myocardial infarction,7)history of hypertension,8)family history,etc.2.Collect the auxiliary examinations data of the patients including: 1)UCG,2)24-hour dynamic electrocardiogram,3)ECG,4)blood lipid,5)glucose,6)thyroid function,7)creatinine and urea nitrogen,8)ion 9)liver function,etc.3.Record the 24-hour dynamic ECG data including: heart rate variability,24-hour total heart beats and average heart rate,etc.Record the PR interval,QRS interval and QT/QTc in the ECG at the onset ofventricular tachycardia,and after patient's recovery to sinus rhythm.4.Invite two experienced ECG physicians to make judgement the 12-lead ECG of the patients respectively.If their judgements of the f QRS complex are consistent,they are recorded and counted.If a difference occurs,a third ECG specialist shall be invited to continue to analyze and judge.5.Statistical analysis of the collected data is made and conclusions are reached.Results: 1.Among the 308 VT patients enrolled in the study,f QRS was detected in a total of 172 sinus rhythm ECGs,of which males accounted for 55.22%(95 out of 172).The detection rate of f QRS is 55.8%.2.Patients in the f QRS(+)group are characterized by old age,a high percentage of MI in their past medical history,poor blood lipid control.In the meanwhile,they tend to have a longer QRS duration,a higher total of abnormal heartbeats and VT in 24 hours,and a faster average heart rate(p<0.05).3.Most of the f QRS occurs in the corresponding leads of the inferior myocardium(II,III,av F).When the number of leads present in the f QRS is greater than 3,the patients have higher TSH,greater LV,lower EF,and longer QTc interval(p <0.05).4.Through Pearson's correlation coefficient matrix and analyze the results of the test and examination: LV was significantly associated with urea nitrogen,QRS interval,QTc interval,and 24-hour total abnormal heart rate(p<0.01);there was a significant correlation between magnesium ion and 24-hour average heart rate,p NN50,and 24-hour ventricular tachycardia(p<0.05);there was a significant correlationbetween LVEF and QRS interval and QTc interval(p<0.01);there was a significant correlation between blood glucose and triglycerides(p<0.01).The f QRS study finds that there is a significant correlation between f QRS and TSH,QRS interval,and QTc interval(p<0.01).And it is found out that the total number of VT is significantly correlated with the number of leads in f QRS and QTc interval(P<0.01)in the meanwhile.5.Finally,this paper comprehensively analyzes all data through the random forest method and can predict the VT under the synergy of multiple clinical data,in which f QRS plays a leading role,and QTc interval,QRS interval,TSH,and LV,etc.play an important role.The accuracy of this prediction can reach 64.1%.Conclusion: 1.In organic heart disease with persistent VT,the detection rate of f QRS is 55.8%,which is much higher than that in healthy people.If the f QRS and VT appear in the patient's ECG during the physical examination,the clinician should be hypervigilant for the possibility of the patient complicated with organic heart disease.2.FQRS can be used as an indicator to assess the patient's condition: Patients with ECG f QRS(+)are more likely to have coronary-related disease,arrhythmia and hyperlipidemia than patients with f QRS(-).3.In the ECG after recovery to sinus rhythm,when the number of leads in f QRS is more than 3,the TSH gets higher and the QTc interval longer,and there are more cases of cardiac structural abnormalities(mostly with an increase in the diameter of the left ventricle),with worse systolic function.The more leads in f QRS,the more complex condition and the more serious arrhythmia.4.In the synchrony ECG after the recovery to sinus rhythm,f QRS mostly appears in the inferior wall leads.5.The correlation between f QRS and VT is one of the indicators for the prediction of VT.6.Through the analysis of clinical patient's medical history,laboratory examination and auxiliary examination data,VT can be predicted via the random forest method,the accuracy of which can be as high as 64.1%.