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Electrocardiographic ST segment depression and clinical function in children with Fontan circulation

A Rydberg1, P Rask, D E Teien

  • 1Section of Pediatric Cardiology, Department of Clinical Sciences, Umeå Hospital, S-901 85 Umeå, Sweden.

Pediatric Cardiology
|November 25, 2003
PubMed

Insights

Fontan patients exhibit significant ST depressions on 24-hour ECG, which correlate with their functional status. This finding suggests ambulatory ECG monitoring can assess clinical function in Fontan circulation.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Fontan patients often show ST depressions on exercise tests and ambulatory ECG.
  • The clinical significance of these ST changes in relation to functional capacity is not well-established.

Purpose of the Study:

  • To investigate the correlation between ST depressions detected via 24-hour ambulatory electrocardiography (ECG) and the clinical functional status (NYHA Classification) in children with Fontan circulation.

Main Methods:

  • A cohort of 45 children (15 Fontan, 30 healthy controls) underwent 24-hour ECG monitoring.
  • ST segment depression > 0.20 mV at ST 60 was considered significant.
  • Analysis compared ECG findings with NYHA Functional Classification (I-IV).

Main Results:

  • Significant ST depressions were observed in 12 of 15 Fontan patients, often recurrently.
  • Fontan patients in lower NYHA classes (II-III) showed significantly deeper, longer, and more numerous ST depressions compared to those in NYHA class I (p < 0.003).
  • No ST depressions were found in healthy controls.

Conclusions:

  • 24-hour ambulatory ECG ST depressions are prevalent in Fontan patients and correlate with their functional status.
  • Ambulatory ECG monitoring may serve as a valuable, non-invasive tool for assessing clinical function in pediatric patients with Fontan circulation.

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