title: Relationship between electrocardiographic signs and shunt volume in atrial septal defect.
abstract: BACKGROUND
  The aim of this study was to determine whether electrocardiographic signs correlate with hemodynamics and the magnitude of the intracardiac shunt in children with ostium secundum atrial septal defects (ASD).
  
  
  METHODS
  A total of 100 ASD patients (median age, 6 years 4 months; 54 girls) underwent cardiac catheterization between August 1980 and April 2010. We retrospectively investigated the relationship between electrocardiographic signs and the pulmonary/systemic blood flow ratio (Qp/Qs) in these patients. We also compared 63 postoperative electrocardiograms with those recorded before surgery.
  
  
  RESULTS
  The mean Qp/Qs ratio of the 100 patients was 2.46 ± 0.81 (range, 1.1-5.0). The Qp/Qs ratio in patients with and without right bundle branch block (RBBB) was 2.57 ± 0.82 (n = 73) and 2.15 ± 0.72 (n = 27), respectively (P = 0.016). The Qp/Qs ratio in patients with and without isolated negative T-wave was 2.85 ± 0.87 (n = 38) and 2.22 ± 0.68 (n = 62), respectively (P = 0.0003). None of the patients with low Qp/Qs ratio (Qp/Qs ratio ≤ 1.5) had both RBBB and isolated negative T-wave. The prevalence of these two signs decreased from 73.0% (n = 46) and 36.5% (n = 23) to 15.9% (n = 10) and 15.9% (n = 10) after surgical repair, respectively.
  
  
  CONCLUSIONS
  RBBB and isolated negative T-wave in the precordial leads are well correlated with high Qp/Qs ratio in ASD patients.
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Somura
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Ukiami
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Sagawa
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Ouki
authors.initials: O
authors.lastname: Furukawa
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Hoshino
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Fujino
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeuchi
mesh_terms: D000293:Adolescent; D006328:Cardiac Catheterization; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D057234:Preoperative Period; D012189:Retrospective Studies
keywords: atrial septal defect; electrocardiogram; pediatric; right bundle branch block; right ventricle