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Relationship between electrocardiographic signs and shunt volume in atrial septal defect
Author(s) -
Somura Junpei,
Nakagawa Masao,
Ukiami Masami,
Sagawa Hironori,
Furukawa Ouki,
Hoshino Shinsuke,
Fujino Hidetoshi,
Takeuchi Yoshihiro
Publication year - 2015
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12569
Subject(s) - medicine , cardiology , shunt (medical) , electrocardiography
Background The aim of this study was to determine whether electrocardiographic signs correlate with hemodynamics and the magnitude of the intracardiac shunt in children with ostium secundum atrial septal defects ( ASD ). Methods A total of 100 ASD patients (median age, 6 years 4 months; 54 girls) underwent cardiac catheterization between A ugust 1980 and A pril 2010. We retrospectively investigated the relationship between electrocardiographic signs and the pulmonary/systemic blood flow ratio ( Q p/ Q s) in these patients. We also compared 63 postoperative electrocardiograms with those recorded before surgery. Results The mean Q p/ Q s ratio of the 100 patients was 2.46 ± 0.81 (range, 1.1–5.0). The Q p/ Q s ratio in patients with and without right bundle branch block ( RBBB ) was 2.57 ± 0.82 ( n = 73) and 2.15 ± 0.72 ( n = 27), respectively ( P = 0.016). The Q p/ Q s ratio in patients with and without isolated negative T ‐wave was 2.85 ± 0.87 ( n = 38) and 2.22 ± 0.68 ( n = 62), respectively ( P = 0.0003). None of the patients with low Q p/ Q s ratio ( Q p/ Q s ratio ≤ 1.5) had both RBBB and isolated negative T ‐wave. The prevalence of these two signs decreased from 73.0% ( n = 46) and 36.5% ( n = 23) to 15.9% ( n = 10) and 15.9% ( n = 10) after surgical repair, respectively. Conclusions RBBB and isolated negative T ‐wave in the precordial leads are well correlated with high Q p/ Q s ratio in ASD patients.