Laparoscopic surgery: does it increase the probability of atrial and ventricular arrhythmias in children?
OBJECTIVE
Despite the minor physiologic changes those occur during laparoscopic procedures, pneumoperitoneum with CO2 insufflation may induce alterations in electrocardiographic (ECG) variables, which may predict severe atrial and ventricular arrhythmias. This study aims to assess QT dispersion (QTD) and P wave dispersion (PWD) changes in children who have undergone laparoscopic appendectomy.


METHODS
Sixteen patients (12 males and 4 females) who had preoperative diagnosis of appendicitis were included in the study. As laparoscopic exploration revealed appendicitis in all patients, laparoscopic appendectomy was performed. Preinsufflation (ECG1), postinsufflation (ECG2), predesufflation (ECG3), and postdesufflation (ECG4) ECGs were achieved at a speed of 25 mm/s for QTD and PWD analyses.


RESULTS
Although mean corrected QTD and PWD at ECG2 and ECG3 were significantly greater than ECG1 and ECG4, those changes induced by insufflation of CO2 were reversible.


CONCLUSIONS
The clinical significance of pneumoperitoneum, which causes an increase in corrected QTD and PWD in children, remains to be determined with further studies.
Ciftci
Ozgur
O
Department of Cardiology, Baskent University, Konya, Turkey. drozgurciftci@gmail.com
Elemen
Levent
L
Elemen
Funda
F
Yildirir
Aylin
A
Caliskan
Mustafa
M
Erdogan
Dogan
D
Muderrisoglu
Haldun
H
D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*