Impact of right ventricular size on ECG after percutaneous closure of atrial septal defect with Amplatzer Septal Occluder.
OBJECTIVE
To assess ECG changes after percutaneous atrial septal defect (ASD) closure in children with significant left-to-right shunt.


METHODS
Analysis of data of 36 consecutive children with an ASD who had successful percutaneous ASD closure with an Amplatzer Septal Occluder. Assessment comprised echocardiography and ECG the day before and after the procedure and at 1, 6 and 12 months follow-up.


RESULTS
The median age (interquartile range) of children was 7.3 (5.3) years. On the day after the procedure the end diastolic diameter of the right ventricle showed already a diminution (34 (12) mm/m2 before intervention vs. 32 (12) mm/m2). ECG changes were first observed at 1 month follow-up (PR interval before intervention 139 (20) ms vs. 132 (20) ms; QRS duration 88 (18) ms vs. 82 (19) ms) and at 6 months follow-up (QRS axis 77 degrees (33) before intervention vs. 72 degrees (53)). With the exception of the QRS duration, ECG intervals and axis were in a normal range in all patients before the procedure. Median QRS duration normalised at 1 year follow-up (83 (8) ms).


CONCLUSIONS
After transcatheter ASD closure, decrease in right ventricular size began rapidly and was followed by reduction of the QRS duration and PR interval within weeks. Shifting to the left of the QRS axis was observed within 6 months follow-up. This study showed that ECG changes due to right ventricular volume overload can regress and normalise after percutaneous ASD closure in children.
Di Bernardo
Stefano
S
Division of Cardiology, University Children's Hospital, Zurich, Switzerland. stefano.di-bernardo@chuv.ch
Berger
Felix
F
Fasnacht
Margrit
M
Bauersfeld
Urs
U
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D012189:Retrospective Studies; D016896:Treatment Outcome; D016278:Ventricular Function, Right