Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1377
2
1
gregorian
1998
5
1
12
1
online
1
fulltext
en
STUDY OF LATE POTENTIALS IN PEDIATRIC PATIENTS AFTER OP EN HEART SURGERY
Pediatric
Pediatric
Original Research
Original Research
This study was conducted to assess the incidence of abnormalities of
ventricular depolarization (late potentials) in children with sinus rhythm after open
heart surgery and their relation to spontaneous ventricular tachycardia. Open heart
surgery, particularly operations involving ventriculotomy, may predispose patients
to the development of ventricular tachycardia (VT) or ventricular fibrillation (VF).
Previous studies on children with right bundle branch block (RBBB) have shown
that late potentials may be a risk factor for developing VT or VF following open
heart surgery. After corrective surgery for congenital heart defects, scars may
create fractionation and delay of the electrical signals in the heart muscle,
providing a substrate for arrhythmias and sudden cardiac death.
To find normal values of signal averaged EKG (SA-EKG) indices in children
and their changes following open heart surgery, we studied 20 normal children and
20 children with congenital heart disease (CHD) following total correction of heart
defects without ventriculotomy. All patients were in normal sinus rhythm and did
not have RBBB. The mean age was 8.8±2.6 years for the control group and K 1±2.1
years for the operated patients. SA -EKG was performed for the operated group on
the day before and on the 2nd and 4th days after operation. Noise level was less
than 1 microvolt. The SA-EKG parameter values were as follows: control group:
filtered QRS-duration 40Hz (F. QRS-d), 84.2±9.5 ms high frequency low
amplitude signals (HFLA) , 18.9±9.5 ms rootmean square 40 (RMS 40), 181.0±89.4
µv patients: F.QRS-d, 97.2±19.3*, 116.4±21.2* and 122.2±220.4before operation,
2nd day post-op and 4th day post-op, respectively HFLA, 205±22.3, 8.9±7.0*,
and 15.4±16.4ms,respectively RMS40, 146.4±11O.9,92.1±65.9,and 112.8±60.3,
respectively. Values marked with an asterisk are statistically significant.
Except for a significant difference between the QRS duration of normal
children and pre-op values of operated patients (p<0.05), there was no remarkable
difference between the SA-EKG values pre- and postoperatively.
This study in which there was no RBBB, contrary to previous studies, shows
that SA-EKG indices are not a predictive value for VT or VF postoperatively.
Increased thickness of the ventricular myocardium may be a reason for the
increased QRS duration before operation.
Late potentials, Ventricular arrhythmias, Operated congenital heart defect in children, Signal-averaged electrocardiography.
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http://mjiri.iums.ac.ir/browse.php?a_code=A-10-298-487&slc_lang=en&sid=1
ALI AKBAR
ZEINALOO
20031947532846004885
20031947532846004885
Yes
the Department of Pediatric Cardiology, Childen's Medical Center, 62 Gharib Ave., 14194-Tehran, Islamic Republic of Iran.
JG
SHAKIBI
20031947532846004886
20031947532846004886
No
From the Department of Pediatric Cardiology, Shahid Rajai Heart Hospital, Tehran
A
A. SHAH-MOHAMMADI
20031947532846004887
20031947532846004887
No
From the Department of Pediatric Cardiology, Shahid Rajai Heart Hospital, Tehran