Immediate and short term effects of percutaneous atrial septal defect device closure on cardiac electrical remodeling in children

Abstract

Background: The beneficial effects of atrial septal defect (ASD) device closure on electrical cardiac remodeling are well established. The timing at which these effects starts to take place has yet to be determined. Objectives: To determine the immediate and short term effects of ASD device closure on cardiac electric remodeling in children. Methods: 30 pediatric patients were subjected to 12 lead Electrocardiogram immediately before ASD device closure, 24 h post procedure, 1 and 6 months after. The maximum and minimum P wave and QT durations in any of the 12 leads were recorded and P wave and QT dispersions were calculated and compared using paired T test. Results: The immediate 24 h follow up electrocardiogram showed significant decrease in P maximum (140.2 ± 6 versus 130.67 ± 5.4 ms), P dispersion (49.73 ± 9.01 versus 41.43 ± 7.65 ms), PR interval (188.7 ± 6.06 ms versus 182.73 ± 5.8 ms), QRS duration (134.4 ± 4.97 ms versus 127.87 ± 4.44), QT maximum (619.07 ± 15.73 ms versus 613.43 ± 11.87), and QT dispersion (67.6 ± 5.31 versus 62.6 ± 4.68 ms) (P = 0.001). After 1 month all the parameters measured showed further significant decrease with P dispersion reaching 32.13 ± 6 (P = 0.001) and QT dispersion reaching 55.0 ± 4.76 (P = 0.001). These effects were maintained 6 months post device closure. Conclusion: Percutaneous ASD device closure can reverse electrical changes in atrial and ventricular myocardium as early as the first 24 h post device closure. Keywords: ASD, Device closure, Electric remodeling, Dispersion