title: Electrocardiographic characteristics of patients with funnel chest before and after surgical correction using pectus bar: A new association with precordial J wave pattern.
abstract: OBJECTIVE
  Abnormal ECG findings suggestive of cardiac disease are frequent in patients with funnel chest, although structural heart disease is rare. Electrocardiographic characteristics and changes following new surgical treatments in young adults are not described so far. The aim of the study was to analyze electrocardiographic characteristics of patients with funnel chest before and after minimally invasive funnel chest correction by the Nuss procedure.
  
  
  METHODS
  Twenty-six patients with surgical correction of funnel chest using pectus bar were included. Twelve-lead ECGs before and later than one year after surgery were analyzed.
  
  
  RESULTS
  In postoperative ECGs, amplitude of P wave in lead II and negative terminal amplitude of P wave in lead V1 decreased from 0.13 to 0.10mV (p=0.03), and from 0.10 to 0.04mV (p<0.001), respectively. Mean QRS duration decreased from 108ms to 98ms (p=0.003) after correction. A pathological left and right Sokolow-Lyon index was observed in 35% and 23% of patients before, versus 8% (p=0.04) and 0% (p=0.01) after correction, respectively. In contrast, the rate of patients with J wave pattern in precordial leads V4-V6 increased from 8% before to 42% after surgery (p=0.004).
  
  
  CONCLUSIONS
  ECG abnormalities in patients with funnel chest are frequent, and can normalize after surgical correction by the Nuss procedure. De novo J wave pattern in precordial leads V4-V6 is a frequent finding after surgical funnel chest correction using pectus bar.
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: hildegard.tanner@insel.ch.
authors.forename: Hildegard
authors.initials: H
authors.lastname: Tanner
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Désirée
authors.initials: D
authors.lastname: Bischof
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Roten
authors.affiliation: Department of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Beatrix
authors.initials: B
authors.lastname: Hoksch
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Jens
authors.initials: J
authors.lastname: Seiler
authors.affiliation: Department of General Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Ralph A
authors.initials: RA
authors.lastname: Schmid
authors.affiliation: Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Etienne
authors.initials: E
authors.lastname: Delacrétaz
mesh_terms: D000293:Adolescent; D000328:Adult; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005660:Funnel Chest / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D019736:Prostheses and Implants; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
keywords: ECG; funnel chest; pectus bar; precordial J wave pattern; surgical correction