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Longitudinal Evaluation of P-Wave Dispersion and P-Wave Maximum in Children After Transcatheter Device Closure of Secundum Atrial Septal Defect

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Abstract

Transcatheter device closure of the secundum atrial septal defect (ASD) in children prevents atrial arrhythmias in older age. However, the benefits of favourable atrial electrocardiographic markers in these children remain elusive. We aimed to review the electrocardiographic markers of atrial activity in a longitudinal fashion. We retrospectively reviewed longitudinal data of all children who underwent transcatheter device closure at the National University Hospital between 2004 and 2013. The inclusion criteria included the presence of a secundum-type ASD with left to right shunt and evidence of increased right ventricular volume load (Q p/Q s ratio >1.5 and/or right ventricular dilatation). A total of 25 patients with a mean follow-up of 44.7 ± 33.47 (7.3–117.4) months were included. P maximum and P dispersion decreased at 2 months, P amplitude at 1 week and remained so until last follow-up. A positive trend was seen with a correlation coefficient of +0.12 for P maximum, +0.08 for P dispersion and 0.34 for P amplitude. There was a higher baseline P amplitude and P dispersion in patients who were older than 10 years and a non-significant trend to support an increase in both P maximum (71.0 ± 8.8 vs. 73.2 ± 12.7), P dispersion (17.0 ± 6.5 vs. 22.0 ± 11.3) and P amplitude (0.88 ± 0.25 vs. 1.02 ± 0.23) in patients with an ASD more than 15 mm compared with an ASD <15 mm. There is reduction in both P maximum and P dispersion as early as 2 months, which persisted on follow-up. Earlier closure may result in more favourable electrocardiographic results.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This was a retrospective study, and for this type of study, formal consent is not required.

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Correspondence to Swee Chye Quek.

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Robert Teodoro Grignani and Kim Martin Tolentino have contributed equally to this study.

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Grignani, R.T., Tolentino, K.M., Rajgor, D.D. et al. Longitudinal Evaluation of P-Wave Dispersion and P-Wave Maximum in Children After Transcatheter Device Closure of Secundum Atrial Septal Defect. Pediatr Cardiol 36, 1050–1056 (2015). https://doi.org/10.1007/s00246-015-1119-3

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  • DOI: https://doi.org/10.1007/s00246-015-1119-3

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