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Electrophysiologic assessment before and after surgery for atrial defects: influence of volume overload of the right heart on the conduction system

Nihon Kyobu Geka Gakkai 35(11): 1974-1979
Electrophysiologic assessment before and after surgery for atrial defects: influence of volume overload of the right heart on the conduction system
Electrophysiologic studies were performed in 27 children with atrial septal defect (ASD) before and after surgical closure. Basal cycle length (BCL), AH and HV intervals, paced atrial cycle length at which the atrioventricular node developed the wenckebach phenomenon (WCL), sino-atrial conduction time (SACT), corrected sinus node recovery time (CSNRT) and atrial effective refractory period (AERP) were determined. Electrophysiologic abnormalities were found in 78% of 27 children studied preoperatively. They were found in every item except BCL. There was no correlation between the Qp/Qs ratio and each item. Twenty-seven children studied preoperatively were divided into two groups, younger and older, according to age. In the older group, the mean values of every item were higher than in the younger group. Sixteen children with surgical intervention could be compared preoperatively and postoperatively. AH, WCL, CSNRT and AERP decreased significantly after operation. In WCL, CSNRT and AERP, most of abnormal values before operation decreased to normal range after operation. These observations indicate that the conduction system dysfunctions are present after operation of ASD, increase with age and can be restored to some extent by an operation. Conduction system dysfunctions would seem to be associated with hemodynamics of ASD, and it is suggested that volume overload of the right heart in ASD leads to conduction system dysfunctions.

Accession: 005349256

PMID: 3446712

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