title: Prognostic significance of the absence of normal septal Q waves before aortic valve replacement.
abstract: OBJECTIVE
  Aim of this study was to investigate the prognostic significance of absence of septal Q waves in patients scheduled for aortic valve replacement.
  
  
  METHODS
  Sixty-one patients who underwent isolated aortic valve replacement for aortic stenosis were retrospectively evaluated. Septal Q waves were defined as Q waves of<2mm in amplitude and<40ms in width and absence of septal Q waves was defined as simultaneous loss of Q waves from at least three of the leads I, aVL, V5 and V6. Septal Q waves were absent in 17 patients (Group AQ, 27.8%) and were present in 44 patients (Group PQ, 72.1 %) preoperatively. Newly developed AV block>1st degree and newly developed left bundle branch block were primary endpoints.
  
  
  RESULTS
  Preoperatively, absence of normal septal Q waves was significantly associated with increased risk of postoperative AV block (HR: 11.18, range 1.37-91.21, 95% CI, p=0.02) whereas it was not associated with increased risk for newly developed LBBB (HR: 3.15 0.62-15.83, 95% CI, p=0.16).
  
  
  CONCLUSIONS
  Absence of normal septal Q waves in the preoperative ECG may predict further delay in conduction which might develop in the early postoperative course of aortic valve replacement.
authors.affiliation: Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Tas
authors.forename: Eray
authors.initials: E
authors.lastname: Aksoy
authors.forename: Fuat
authors.initials: F
authors.lastname: Buyukbayrak
authors.forename: Arzu
authors.initials: A
authors.lastname: Antal
authors.forename: Guclu
authors.initials: G
authors.lastname: Donmez
authors.forename: Ruken Bengi
authors.initials: RB
authors.lastname: Bakal
authors.forename: Rahmi
authors.initials: R
authors.lastname: Zeybek
authors.forename: Hasan
authors.initials: H
authors.lastname: Sunar
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D054537:Atrioventricular Block / Q000175:diagnosis* / Q000453:epidemiology; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology