The effects of surgical repair on P-wave dispersion in children with secundum atrial septal defect.
BACKGROUND
Atrial septal defect (ASD) is one of the most common congenital heart diseases in children. P-wave dispersion has been reported to be associated with non-homogeneous propagation of sinus impulses. The heterogeneity of atrial conduction time may predispose the atria to arrhythmias. The aim of this study was to determine the impact of surgical repair on P-wave indices in children with isolated secundum ASD.


METHODS
Children with isolated secundum ASD undergoing surgical repair (n=50; mean age, 7.0+/-3.0 years) and healthy controls (n=51; mean age, 7.6+/-2.7 years) were compared. Maximum P-wave duration (Pmax), shortest duration (Pmin) and P-wave dispersion (Pd) were measured using 12-lead surface electrocardiography.


RESULTS
Mean Pmax was found to be significantly higher in children with ASD compared with controls (95.2+/-10.8 vs 84.1+/-9.2 msec; P<0.001), and Pd before surgery was significantly higher compared with controls (47.4+/-12.0 vs 38.8+/-9.7 msec; P<0.001). Both P-wave indices were significantly decreased within the first year after surgical closure - the values decreased to those comparable to healthy controls (Pmax, 86.2+/-9.7 msec; Pd, 39.8+/-10.7 msec; P>0.05).


CONCLUSIONS
Surgical closure of ASD in children decreases Pmax and P-wave conduction time. We speculate that earlier closure of the defect may play an important role in avoiding permanent changes in the atrial myocardium and atrial fibrillation in adulthood.
Yavuz
Taner
T
Department of Paediatrics, Duzce Faculty of Medicine, Duzce, Turkey. taneryavuz@yahoo.com
Nisli
Kemal
K
Oner
Naci
N
Dindar
Aygun
A
Aydogan
Umrah
U
Omeroglu
Rukiye Eker
RE
Ertugrul
Turkan
T
D002648:Child; D004562:Electrocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male