Evaluation of electrocardiographic changes after arterial switch operation

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Cardiac Electrophysiology

Background:

• Transposition of Great Arteries (TGA) is a critical congenital heart defect.
• Anatomic correction via Arterial Switch Operation (ASO) in early infancy offers favorable outcomes.
• Post-surgical electrocardiographic (ECG) assessment is crucial for monitoring cardiac health.

Purpose of the Study:

• To evaluate specific electrocardiographic (ECG) changes in children following an uncomplicated Arterial Switch Operation (ASO).
• To compare ECG parameters, including P-wave and QT dispersion, between TGA patients post-ASO and a healthy control group.
• To identify potential electrophysiological risks associated with ASO in pediatric patients.

Main Methods:

• Twelve-lead ECGs were recorded from 33 pediatric patients after TGA correction (ASO).
• ECG data, including P-wave and QT dispersion, were compared with 33 age- and gender-matched controls.
• M-mode echocardiography was performed on both groups; statistical analysis used Student's t-test and Pearson correlation.

Main Results:

• Patients exhibited significant differences in ECG findings, including inverted T waves, altered P wave and R wave amplitudes, prolonged corrected QT interval, and longer PR intervals.
• Higher incidences of right bundle branch block, bifascicular block, and first-degree AV block were observed in the post-ASO group.
• While QT dispersion showed no significant difference, P wave dispersion was notably higher in patients compared to controls.

Conclusions:

• Post-ASO pediatric patients with TGA demonstrate distinct electrocardiographic abnormalities, notably right bundle branch block and first-degree AV block.
• Elevated P wave dispersion in these patients suggests an increased susceptibility to atrial arrhythmias.
• Long-term cardiac monitoring is essential for managing these patients effectively.