The Impact of Transcatheter Atrial Septal Defect Closure on Ventricular Repolarization Parameters in Children: Results from a 15-Year Single-Center Tertiary Care Experience

• Published in: Kardiyovasküler tıp e dergisi 2023-09, Vol.11 (3), p.101-107
• Main Authors: Yıldız, Kaan, Kır, Mustafa, Armağan, Coşkun, Genç, Halise Zeynep, Çeliktepe, Veysel, Bozyer, Hazer Ercan, Akçura, Yağmur Damla, Bardak, Hüseyin, Bayam, Yunus Sezer, Ünal, Nurettin
• Format: Article
• Language: English
• Subjects: Cardiac arrhythmia; Electrocardiography; Heart; Mortality; Normal distribution; Patients; Pediatrics; Pulmonary arteries; Sinuses; University faculty
• ISSN: 2147-1924; 2147-1924
• DOI: 10.32596/ejcm.galenos.2023.2023-1-6

Objectives: Atrial and ventricular arrhythmias can be observed in children after transcatheter atrial septal defect (ASD) closure. This study investigated ventricular repolarization parameters, which are considered to indicate an increased risk of arrhythmias in patients with transcatheter ASD closure. Materials and Methods: The study included 225 patients aged 0-18 years who underwent transcatheter ASD closure at a tertiary medical school university hospital between 2005 and 2020. Heart rate, Pmax, Pmin, Pdispersion, QTmax, QTmin, QTdispersion, QTcmax, QTcmin, QTcdispersion, Tp-e interval, Tp-e/QT, and Tp-e/QTc values were calculated electronically in 12-lead electrocardiographies (ECGs) taken before the procedure and at 24 h, 1, 6, and 12 months after the procedure. Results: Of the 225 patients who underwent transcatheter closure, 144 (64%) were female and 81 (36%) were male. The mean age at angiography was 9.2±4.1 years, and the mean weight was 29.6±14.3 kg. Statistically significant differences were observed in the Tp-e interval and Tp-e/QTc values measured before transcatheter closure compared with those measured after closure (p=0.028; p=0.032), while no significant differences were found between the two groups in terms of other ECG parameters. A negative correlation was found between P and QT dispersion measured before transcatheter closure and after closure (r=-0.408; p=0.041). Conclusion: Changes in ventricular repolarization parameters were observed in children after transcatheter ASD closure. QT dispersion, Tp-e interval, and Tp-e/QTc ratios, which are sensitive indicators of ventricular arrhythmias, were significant in the post-closure group. Therefore, careful evaluation of these parameters, which are markers for predicting ventricular arrhythmias before and after ASD closure, will serve as a warning for potentially fatal arrhythmias of vital importance in the long term. Each patient undergoing transcatheter ASD closure should be monitored with a 12-lead ECG for atrial and ventricular depolarization and repolarization parameters, and annual 24-hour Holter ECG monitoring should be performed to detect arrhythmias.