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


Tomaske, Maren; Harpes, Paul; Prêtre, Rene; Dodge-Khatami, Ali; Bauersfeld, Urs (2007). Evolution of paced QRS and QTc intervals in children with epicardial pacing leads. Clinical Research in Cardiology, 96(11):787-793.

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

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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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 November 2007
Deposited On:29 Nov 2018 15:22
Last Modified:26 Apr 2019 04:50
Publisher:Springer
ISSN:1861-0684
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00392-007-0558-0
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencespringer101007s0039200705580 (Library Catalogue)
PubMed ID:17687506

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