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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
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Repolarization Patterns in Congenital Heart Disease.

Wael N Lotfy1, Nashwa M Samra2, Mohamed E Al Ghwass3

  • 1Pediatrics Department, Cardiology Department, Cairo University, Giza City, Egypt.

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|June 12, 2016
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Pediatric patients with congenital heart disease show altered repolarization patterns. Prolonged QT intervals and early repolarization were observed, indicating increased risk of ventricular arrhythmia.

Keywords:
Congenital heart diseasesEarly repolarizationQT interval

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Area of Science:

  • Cardiology
  • Pediatrics
  • Electrophysiology

Background:

  • Congenital heart diseases (CHDs) can affect myocardial repolarization.
  • Prolonged QT interval (QTc) is a marker for ventricular arrhythmia risk.
  • Understanding repolarization patterns in pediatric CHDs is crucial for risk stratification.

Purpose of the Study:

  • To investigate repolarization patterns, specifically QT interval and early repolarization, in pediatric patients with cyanotic and acyanotic congenital heart diseases.
  • To identify associations between repolarization abnormalities and clinical parameters in these patients.

Main Methods:

  • A cross-sectional case-control study involving 100 pediatric patients with CHDs (50 cyanotic, 50 acyanotic) and 50 healthy controls.
  • Measurements included oxygen saturation, echocardiography, and 12-lead electrocardiogram (ECG) to determine corrected QT (QTc) interval.
  • Statistical analysis was performed to compare groups and identify significant associations.

Main Results:

  • Mean QTc was significantly higher in acyanotic CHDs with volume overload compared to controls (0.426s vs 0.4s).
  • Increased left ventricular end-diastolic dimension was significantly associated with QTc prolongation (p=0.01).
  • Early repolarization was more prevalent in patients with CHDs (18% acyanotic, 48% cyanotic) than controls (6%).
  • Decreased oxygen saturation was significantly associated with early repolarization (p=0.01).

Conclusions:

  • Acyanotic congenital heart diseases with volume overload and increased left ventricular end-diastolic dimension are associated with prolonged QTc.
  • Decreased oxygen saturation is linked to early repolarization in pediatric patients with congenital heart disease.
  • These findings highlight the importance of monitoring repolarization in pediatric CHD patients for arrhythmia risk assessment.