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Early ECG changes after total surgical correction of Tetralogy patients surgery in five years in the pediatric heart surgery center of Fars province
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Nima Mehdizadegan   , Parvin Abbasi , Amir Naghshzan 1, Hamid Mohammadi , Ahmad Ali Amirghofran , Hamid Amoozgar , Mohammad Reza Edraki |
| 1- , Amirnaghshzan@gmail.com |
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Abstract: (221 Views) |
Background: Tetralogy of Fallot is the most common congenital cyanotic disease, and the severity of the clinical symptoms of the disease depends on the degree of right ventricular outflow tract stenosis. However, most babies have some degree of cyanosis. Surgical treatment of the disease has resulted in a perfect survival rate. However, problems such as right ventricular outflow tract re-stenosis, pulmonary valve regurgitation, ventricular dysfunction, and ventricular arrhythmias may occur.
Material and method: In this study, we reviewed 116 tetralogy patients who underwent total surgical correction. Six patients died during or immediately after the surgery. ECGs were taken at 3 hours to 3 days after the surgery for PR INTERVAL, QRS DURATION, QTC INTERVAL, and ST segment changes. Also, the types of arrhythmia that occurred in this period were analyzed.
Results: Prolongation of PR interval was observed in 6 patients (5.5%), and first-degree heart block was observed in 38 patients (34.5%). QRS complex time was prolonged in 40 patients (36.4%), and QTC prolongation was observed in 58 patients (52.7%). ST segment was unchanged in 80.9%, nine patients (8.2%) had st elevation, and 12 patients (10.9%) had st depression. No significant relationship existed between changes in pr interval, QRS, QTC, and ST segment with age and sex. (p-value less than 0.05)
Eighty patients had sinus rhythm, and 30 had arrhythmia or non-sinus rhythm. The most common arrhythmia seen in these patients was JET (8 patients (7.27%), and the second most common arrhythmia was first-degree heart block, which was seen in 6 patients (5.45% of patients). RBBB with sinus rhythm was seen in 40 patients (36.4%).
CONCLUSION: After tetralogy repair surgery, a series of arrhythmias may occur, and the patient needs re-intervention, the most common of which is JET arrhythmia. The second arrhythmia is first-degree heart block. RBBB with sinus rhythm was seen in 36.4%. QTC prolongation is common in these patients (52.7%), which increases the chance of torsade points arrhythmia. Therefore, these patients need more follow-up after surgery.
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| Keywords: Tetrallogy of Fallot, Arrhythmia, ECG |
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Type of Study: Applicable |
Subject:
Clinical
Received: 2023/10/23 | Accepted: 2024/08/20 | Published: 2024/09/9
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