Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery

BAYSAL, TAMER; SARIGÜL, Ali; Alp, Hayrullah; NARİN, Cüneyt

Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery

Hayrullah ALP, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Pediatrik Kardiyoloji Bilim Dal, Konya, Türkiye)

Cüneyt NARİN, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Konya, Türkiye)

Tamer BAYSAL, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Pediatrik Kardiyoloji Bilim Dal, Konya, Türkiye)

Ali SARIGÜL (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Konya, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

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Yıl: 2012 Cilt: 20 Sayı: 4 Sayfa Aralığı: 716 - 721 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery

Öz:

Amaç: Çalışmada doğuştan kalp cerrahisi yapılan çocuklarda ameliyat öncesi ve sonrası QTc dispersiyonu değişkenliği değerlendirildi. Çalışma planı: Ekim 2006 - Mart 2011 tarihleri arasında doğuştan kalp cerrahisi yapılan ve ilk dahil edilme kriterlerini karşılayan ardışık 279 hasta (144 kadın, 135 erkek; ort. yaş 56.6±5.0 ay; dağılım 15 gün-17 yaş) çalışmaya alındı. QTc dispersiyon ölçümleri, hastalardan ameliyat öncesi (bir ay) ve ameliyat sonrası (bir hafta) dönemde elde edilen standart 12 derivasyonlu istirahat elektrokardiyogramlarından hesaplandı. Bulgular: Kardiyak cerrahi yapılan tüm hastaların %75.9unda QTc dispersiyonu, ameliyat sonrası ameliyat öncesinden istatistiksel olarak yüksek bulundu (p<0.001). Çalışma grubunda en sık tespit edilen doğuştan kalp hastalıkları ventriküler septal defekt (VSD) (%36.9) ve sekundum atriyal septal defekt (ASD) (%18.2) idi. Ventriküler septal defekt, atriyoventriküler septal defekt, Fallot tetrolojisi (TOF) ve sekundum ASD onarımları QTc dispersiyonundaki artış için majör risk faktörleriydi. Ancak, VSD ile pulmoner stenoz onarımı, koarktasyonda aortun uç uca anostomozu, patent duktus arteriozus ligasyonu ve divizyonu, pulmoner bant ve Glenn prosedürü yapılan çocuklarda ameliyat öncesi ve sonrası QTc dispersiyonları arasında istatistiksel fark bulunmadı. Yapılan kardiyak ameliyatın tipine göre ortaya çıkan aritmiler, uzun QTc dispersiyonu olan grupta, olmayanlara kıyasla, istatistiksel olarak yüksekti. Sonuç: QTc dispersiyonu ölçümü aritmilerin araştırılmasında kullanışlı ve invaziv olmayan bir elektrokardiyografik testtir. Çalışma sonuçları, QTc dispersiyonunun ameliyat sonrası dönemde kullanımının ortaya çıkacak aritmilerin öngörüsünde yardımcı olabileceğini göstermektedir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Doğuştan kalp cerrahisi yapılan çocuklarda aritmi gelişiminin ö ngörüsünde ameliyat öncesi ve sonrası düzeltilmiş QT dispersiyonunun değer lendirilmesi

Öz:

Background: The aim of this study was to evaluate pre- and postoperative QTc dispersion variability in children undergoing congenital cardiac surgery. Methods: Between October 2006 and March 2011, 279 consecutive patients (144 females, 135 males; mean age 56.6±5.0 months; range 15 days to 17 years) who met initial inclusion criteria and underwent congenital cardiac surgery were included. QTc dispersion measurements were calculated based on the standard 12-lead resting electrocardiograms of the patients in the preoperative (one month) and postoperative (one week) period. Results: In 75.9% of all patients with cardiac surgery, postoperative QTc dispersion was statistically higher from preoperative QTc dispersion (p<0.001). Ventricular septal defect (VSD) (36.9%) and secundum atrial septal defect (ASD) (18.2%) were the most common congenital heart diseases in the study population. Repair of VSD, atrioventricular septal defect, tetralogy of Fallot, (TOF) and secundum ASD were the major risk factors for increased QTc dispersion. However, no statistical difference was found between pre- and postoperative QTc dispersion in children who underwent repair of VSD and pulmonary stenosis, end-to- end anastomosis of aorta for coarctation, patent ductus arteriosus ligation and division, pulmonary banding, and Glenn procedure. The occurrence of arrhythmia in prolonged QTc dispersions according to the type of cardiac surgery was statistically higher from those without prolonged QTc dispersion. Conclusion: QTc dispersion measurement is a useful noninvasive electrocardiographic test in the evaluation of arrhythmias. The study results suggest that use of QTc dispersion in the postoperative period may be helpful in the prediction of the development of arrhythmias.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1.Garson A Jr, Dick M 2nd, Fournier A, Gillette PC, Hamilton R, Kugler JD, et al. The long QT syndrome in children. An international study of 287 patients. Circulation 1993;87:1866 -72.
2.Krasner BS, Girdwood R, Smith H. The effect of slow releasing oral magnesium chloride on the QTc interval of the electrocardiogram during open heart surgery. Can Anaesth Soc J 1981;28:329-33.
3.Punn R, Lamberti JJ, Balise RR, Seslar SP. QTc prolongation in children following congenital cardiac disease surgery. Cardiol Young 2011;21:400-10.
4.Yi G, Poloniecki J, Dickie S, Elliott PM, Malik M, McKenna WJ. Is QT dispersion associated with sudden cardiac death in patients with hypertrophic cardiomyopathy? Ann Noninvasive Electrocardiol 2001;6:209-15.
5.Bazett HC. An analysis of time relations of the electrocardiogram. Heart 1920;7:353-370.
6.OConnor M, McDaniel N, Brady WJ. The pediatric electrocardiogram part II: Dysrhythmias. Am J Emerg Med 2008;26:348-58.
7.Kim JH, Noseworthy PA, McCarty D, Yared K, Weiner R, Wang F, et al. Significance of electrocardiographic right bundle branch block in trained athletes. Am J Cardiol 2011;107:1083-9.
8.Gillette P, editor. Pediatric arrhythmias, electrophysiology and pacing. Phildadelphia: W. B. Saunders; 1990.
9.Schwartz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic criteria for the long QT syndrome. An update. Circulation 1993;88:782-4.
10.Priori SG, Schwartz PJ, Napolitano C, Bloise R, Ronchetti E, Grillo M, et al. Risk stratification in the long-QT syndrome. N Engl J Med 2003;348:1866-74.
11.Kenigsberg DN, Khanal S, Kowalski M, Krishnan SC. Prolongation of the QTc interval is seen uniformly during early transmural ischemia. J Am Coll Cardiol 2007;49:1299-305
12.Kawabata M, Hirao K, Takeshi S, Sakurai K, Inagaki H, Hachiya H, et al. Torsades de pointes related to transient marked QT prolongation following successful emergent percutaneous coronary intervention for acute coronary syndrome. J Electrocardiol 2008;41:117-22.
13.Bijl M, Verheugt FW. Extreme QT prolongation solely due to reversible myocardial ischemia in single-vessel coronary disease. Am Heart J 1992;123:524-6.
14.Rebeiz AG, Al-Khatib SM. A case of severe ischemia- induced QT prolongation. Clin Cardiol 2001;24:750.

APA	Alp H, NARİN C, BAYSAL T, SARIGÜL A (2012). Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. , 716 - 721.
Chicago	Alp Hayrullah,NARİN Cüneyt,BAYSAL TAMER,SARIGÜL Ali Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. (2012): 716 - 721.
MLA	Alp Hayrullah,NARİN Cüneyt,BAYSAL TAMER,SARIGÜL Ali Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. , 2012, ss.716 - 721.
AMA	Alp H,NARİN C,BAYSAL T,SARIGÜL A Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. . 2012; 716 - 721.
Vancouver	Alp H,NARİN C,BAYSAL T,SARIGÜL A Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. . 2012; 716 - 721.
IEEE	Alp H,NARİN C,BAYSAL T,SARIGÜL A "Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery." , ss.716 - 721, 2012.
ISNAD	Alp, Hayrullah vd. "Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery". (2012), 716-721.

APA	Alp H, NARİN C, BAYSAL T, SARIGÜL A (2012). Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 20(4), 716 - 721.
Chicago	Alp Hayrullah,NARİN Cüneyt,BAYSAL TAMER,SARIGÜL Ali Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi 20, no.4 (2012): 716 - 721.
MLA	Alp Hayrullah,NARİN Cüneyt,BAYSAL TAMER,SARIGÜL Ali Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.20, no.4, 2012, ss.716 - 721.
AMA	Alp H,NARİN C,BAYSAL T,SARIGÜL A Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2012; 20(4): 716 - 721.
Vancouver	Alp H,NARİN C,BAYSAL T,SARIGÜL A Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2012; 20(4): 716 - 721.
IEEE	Alp H,NARİN C,BAYSAL T,SARIGÜL A "Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 20, ss.716 - 721, 2012.
ISNAD	Alp, Hayrullah vd. "Evaluation of pre- and postoperative corrected QT dispersion predicting the development of arrhythmias in children undergoing congenital heart surgery". Türk Göğüs Kalp Damar Cerrahisi Dergisi 20/4 (2012), 716-721.