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Pulmonary valve replacement in tetralogy of Fallot improves the repolarization.
- Source :
-
International journal of cardiology [Int J Cardiol] 2008 Mar 14; Vol. 124 (3), pp. 301-6. Date of Electronic Publication: 2007 Apr 11. - Publication Year :
- 2008
-
Abstract
- Objective: To assess the effect of pulmonary valve replacement (PVR) on the repolarization of patients with tetralogy of Fallot.<br />Background: Pulmonary valve regurgitation may cause right ventricular failure in adult patients with Fallot's tetralogy. In these patients, prolonged depolarization and disturbed repolarization are associated with ventricular arrhythmias and sudden cardiac death.<br />Methods: Thirty Fallot patients (age 32+/-9 years, 19 male) eligible for PVR were studied with cardiac magnetic resonance imaging (CMR) before and 6 months after PVR. Electrocardiograms obtained during initial and follow-up CMR were analyzed and occurrence of ventricular arrhythmias was studied.<br />Results: Right ventricular end-diastolic volume (RV EDV) decreased from 322+/-87 to 215+/-57 ml after PVR (P<0.0001). The spatial QRS-T angle normalized from 117+/-34 to 100+/-35 degrees , P=0.0004 (normal angle <105 degrees). QT dispersion and T-wave complexity did not change significantly. T-wave amplitude decreased from 376+/-121 to 329+/-100 microV (P=0.01). T-wave area decreased from 43+/-15 to 38+/-13 microV s (P=0.02). Decreases in T-wave amplitude and area were most prominent in the right precordial leads overlying the RV. Three patients had sustained ventricular arrhythmias and one patient died suddenly. These patients had a QRS duration >160 ms. No severe ventricular arrhythmias were found in patients with a RV EDV <220 ml, QRS-T angle <100 degrees , QT dispersion <60 ms or T-wave complexity <0.30.<br />Conclusion: Normal repolarization indices may be associated with the absence of severe ventricular arrhythmias. PVR in Fallot patients with dilated right ventricles has a beneficial effect on electrocardiographic indices of repolarization heterogeneity.
- Subjects :
- Adult
Electrocardiography
Female
Humans
Magnetic Resonance Imaging
Male
Pulmonary Valve Insufficiency diagnosis
Pulmonary Valve Insufficiency physiopathology
Pulmonary Valve Insufficiency surgery
Tachycardia, Ventricular prevention & control
Tetralogy of Fallot diagnosis
Tetralogy of Fallot physiopathology
Treatment Outcome
Heart Conduction System physiopathology
Heart Valve Prosthesis Implantation methods
Pulmonary Valve surgery
Tetralogy of Fallot surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 124
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 17433464
- Full Text :
- https://doi.org/10.1016/j.ijcard.2007.02.006