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Evolution of paced QRS and QTc intervals in children with epicardial pacing leads

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Abstract

Aims

Permanent ventricular pacing in children is associated with ventricular dysfunction due to asynchronous activation. It is unclear whether paced QRS intervals increase disproportionately over time, which could potentially cause ventricular dysfunction.

Methods

A total of 52 children, with bipolar steroideluting epicardial leads implanted at a median age of 5.6 years (0.0–17.4), was analyzed and followed up to 12.2 years (median 3.7). Patients were subdivided in two groups: right (RV, n = 21) and left (LV, n = 31) ventricular pacing. To correct for age, standard deviation scores (Z-scores) for paced QRS and QTc intervals were calculated from published standard-ECG norm-values. As a measure for individual paced QRS and QTc interval changes, a regression slope coefficient (inclinei) was calculated for each patient’s course.

Results

Mean Z-scores for paced QRS intervals at first and last follow-up were 4.7 ± 1.2 and 4.9 ± 0.9 for group RV, 4.4 ± 1.1 and 4.8 ± 1.1 for group LV. Inclinei of paced QRS (group RV: 0.038 [–0.27–0.12], group LV: 0.147 [–0.05–0.30]; p = 0.07) and QTc intervals (group RV: 0.026 [–0.08–0.06], group LV: 0.023 [–0.04–0.09]; p = 0.63) did not differ between both groups and indicated limited interval changes over time.

Conclusion

Neither epicardial pacing of the right nor left ventricle caused disproportionate paced QRS or QTc interval increases over time. An age-related prolongation of the electrical activation unlikely causes ventricular dysfunction.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Maren Tomaske MD & Urs Bauersfeld MD

  2. Biostatistics Unit University, Zurich, Switzerland

    Paul Harpes PhD

  3. Division of Congenital Cardiovascular Surgery, University Children's Hospital, Zurich, Switzerland

    Rene Prêtre MD & Ali Dodge-Khatami MD PhD

Authors
  1. Maren Tomaske MD
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  2. Paul Harpes PhD
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  3. Rene Prêtre MD
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  4. Ali Dodge-Khatami MD PhD
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  5. Urs Bauersfeld MD
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Correspondence to Maren Tomaske MD.

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Tomaske, M., Harpes, P., Prêtre, R. et al. Evolution of paced QRS and QTc intervals in children with epicardial pacing leads. Clin Res Cardiol 96, 787–793 (2007). https://doi.org/10.1007/s00392-007-0558-0

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  • DOI: https://doi.org/10.1007/s00392-007-0558-0

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