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[Electrocardiographic changes in children with surgery for defects of the atrial septum]
1Klinika za djecje bolesti Rebro, Zavod za kardiologiju i reumatologiju Medicinskog fakulteta Sveucilista u Zagrebu.
Insights
This study analyzed electrocardiograms in children after atrial septal defect surgery. Key findings include a gradual P wave narrowing and immediate PQ interval shortening, indicating significant post-operative cardiac electrical changes.
Area of Science:
- Cardiology
- Pediatric Surgery
- Cardiac Electrophysiology
Context:
- Atrial septal defect (ASD) is a common congenital heart defect requiring surgical intervention.
- Post-operative electrocardiographic (ECG) changes are crucial for monitoring recovery and potential complications.
- Long-term follow-up of ECG parameters after ASD repair is essential for understanding cardiac adaptation.
Purpose:
- To evaluate the serial changes in specific electrocardiographic parameters following surgical repair of atrial septal defects in pediatric patients.
- To assess the impact of ASD surgery on P wave, PQ interval, QRS complex duration, and the incidence of right bundle branch block.
Summary:
- Electrocardiograms were analyzed in 44 children before, immediately after, and 6 months to 2 years post-ASD surgery.
- A statistically significant gradual narrowing of the P wave was observed during the follow-up period (p = 0.001).
- The PQ interval duration significantly decreased immediately after surgery (p = 0.001), while QRS complex width remained unchanged. The incidence of right bundle branch block significantly decreased post-surgery (p = 0.0108) and gradually resolved (p = 0.0282).
Impact:
- The findings demonstrate significant, albeit gradual, electrical remodeling of the atria after ASD repair, particularly evident in P wave morphology.
- The immediate reduction in PQ interval and resolution of right bundle branch block suggest improved atrioventricular conduction and resolution of right ventricular conduction delay post-surgery.
- This study provides valuable insights into the long-term electrocardiographic evolution in children following ASD surgery, aiding in clinical management and risk stratification.
Abstract:
Electrocardiograms obtained prior to surgery, after surgery and in the period between 6 months and 2 years following the surgery were analyzed in 44 children operated because of atrial septal defect. The following electrocardiographic parameters were selected: the P wave, PQ interval, QRS complex and right bundle branch block The P wave narrowing developed gradually, i.e. not earlier than the follow-up period, and it was statistically significant (p = 0.001). The duration of the PQ interval decreased significantly right after the operation (p = 0.001). No changes were seen in the width of the QRS complex neither following the surgical procedure nor in the later postoperative period. The number of children with right bundle branch block decreased significantly immediately after the surgery (p = 0.0108). Willson's right bundle branch block disappeared gradually after operation (p = 0.0282).