Longitudinal ECG changes in tetralogy of Fallot and association with surgical repair

• Published in: Frontiers in cardiovascular medicine 2024, Vol.11, p.1349166-1349166
• Main Authors: Bhat, Misha, Malm, Torsten, Sjöberg, Gunnar, Nordenstam, Felicia, Hanséus, Katarina, Rosenkvist, Carl-Johan, Liuba, Petru
• Format: Article
• Language: English
• Subjects: Cardiac and Cardiovascular Systems; Cardiovascular Medicine; Clinical Medicine; electrocardiography; fragmentation; Kardiologi; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; monocusp pulmonary valve; QRS duration; QTc; tetralogy of Fallot; trans-annular patch; valve sparing surgery
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2024.1349166

ECG abnormalities have been linked to adverse changes in right ventricular (RV) morphology and poor clinical outcomes in repaired Tetralogy of Fallot (rTOF). Our aim was to describe how ECG changes progress in early and intermediate follow-up and whether types of surgical strategy at the time of primary repair affected these changes. We studied patients with rTOF born 2000-2018 operated at our institution. Seven time points in relation to primary repair, follow-up, and pulmonary valve replacement (PVR) were identified. Patients correct with valve sparing repair (VSR), trans-annular patch (TAP) including with a monocusp valve (TAP + M) and with at least 3 ECGs were included. PQ interval, QRS duration, dispersion, and fragmentation, QTc duration and dispersion, JTc as well as presence of a right bundle branch block (RBBB) were analyzed. Medical records were reviewed for demographic and surgical data. Two hundred nineteen patients with 882 ECGs were analyzed with a median follow-up time of 12.3 years (8.4, 17) with 41 (19%) needing PVR during the study period. QRS duration increased at time of primary repair to discharge from 66 msec (IQR 12) to 129 msec (IQR 27) (