Evaluation of Electrocardiographic Changes after Arterial Switch Operation

Hamid  Amoozgar; Ahmad Ali Amirghofran; Shirvan  Salaminia; Sirous Cheriki; Mohammad  Borzoee; Gholamhossein  Ajami; Farah  Peiravian

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Evaluation of Electrocardiographic Changes after Arterial Switch Operation

Author(s):

Hamid Amoozgar¹,

Ahmad Ali Amirghofran²,

Shirvan Salaminia^2,*,

Sirous Cheriki³,

Mohammad Borzoee³,

Gholamhossein Ajami³,

Farah Peiravian⁴

1Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2Department of Cardiac Surgery, Shiraz University of Medical Sciences, Shiraz, Iran

3Division of Pediatric Cardiology, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran

4Department of Pediatric, Islamic Azad University, Kazerun Branch, Kazerun, Iran

International Cardiovascular Research Journal:Vol. 8, issue 3; e11065

Published online:Sep 30, 2014

Article type:Research Article

Received:Feb 19, 2017

Accepted:May 20, 2014

How to Cite:Amoozgar H, Amirghofran A A, Salaminia S, Cheriki S, Borzoee M, et al. Evaluation of Electrocardiographic Changes after Arterial Switch Operation.Int Cardiovasc Res J.2014;8(3):e11065.

Abstract

Background: Transposition of Great Arteries (TGA) is a serious congenital heart disease which can be accompanied by good outcomes with anatomic correction within the first few weeks of life.

Objectives: The present study aimed to evaluate electrocardiographic changes in the children with uncomplicated Arterial Switch Operation (ASO).

Patients and Methods: Twelve lead electrocardiograms were obtained from thirty-three patients with TGA after ASO. Then, the patients’ QT-dispersion and P-wave dispersion were compared to those of 33 age- and gender-matched individuals as the normal control group. Both groups were also evaluated by M-mode echocardiography. Student’s t-test and Pearson correlation were used to analyze the data. Besides, P < 0.05 was considered as statistically significant.

Results: The mean age of the patients and the control group was 41 ± 3.7 and 40.12 ± 4.2 months, respectively. Comparison of P wave, T wave, QRS complex, PR interval, QT segment, and corrected QT segment showed significant differences in the frequency of inverted T wave in pericardial leads [V3, V4, V5, and V6] (P = 0.004; more in patients), P wave amplitude in lead II (P < 0.001; more in patients), R wave amplitude in V1 (P = 0.016; smaller in patients), R and S waves amplitude in V6 (P = 0.004 and P = 0.001; taller in patients), corrected QT segment (in lead V5; P < 0.0001: prolonger in patients), and PR interval (P = 0.001; prolonger in patients). However, no significant differences were found regarding the vector axis and heart rate. Right bundle branch block (18% vs. 0%), Bifascicular (3% vs. 0%), and first-degree blocks (15% vs. 0%) were significantly more in the patients. Besides, the PR interval was longer in the corrected complex TGA (146 ± 24.4 vs. 127.7 ± 23.1, P = 0.001). Moreover, R/S ratio in lead V1 was significantly prolonger, among the patients (2.86 ± 3.35 vs. 0.706 ± 0.53, P = 0.002). Nonetheless, no significant was observed between the patients and controls concerning the mean of QT dispersion. On the other hand, the two groups were significantly difference in terms of P wave dispersion (25.7 ± 13.8 vs. 33.74 ± 12.9, P = 0.024).

Conclusions: In this study, first-degree block and right bundle branch were detected in the operated patients with TGA. Increased P dispersion in these patients may increase the risk of atrial arrhythmia. Thus, long-term follow-up is necessary in these patients.

Keywords

Transposition of Great Vessels

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Author(s):

Hamid Amoozgar:[PubMed][Scholar]
Ahmad Ali Amirghofran:[PubMed][Scholar]
Shirvan Salaminia:[PubMed][Scholar]
Sirous Cheriki:[PubMed][Scholar]
Mohammad Borzoee:[PubMed][Scholar]
Gholamhossein Ajami:[PubMed][Scholar]
Farah Peiravian:[PubMed][Scholar]