Document Detail

Diagnosis of trifasicular damage following tetralogy of fallot and ventricular septal defect repair.
MedLine Citation:
PMID:  830214     Owner:  NLM     Status:  MEDLINE    
We evaluated the usefulness of the surface electrocardiogram to predict the presence of postoperative trifascicular damage. We used the pre and postoperative electrocardiograms and postoperative His bundle electrograms from 50 patients an average of 3.8 years following tetralogy of Fallot (TF) and ventricular septal defect (VSD) repair. Right bundle branch block (RBBB) and RBBB with left anterior hemiblock (LAH) developed in 88% and 18% respectively, and 22% had transient postoperative complete heart block (CHB). Mean P-A and A-H conduction times were 16.6 and 84.9 msec and were not different from 37 are-matched normal patients and 61 patients with unoperated TF and VSD. The mean H-V conduction time of 48.5 msec was significantly increased compared to the other two groups. Ten postoperative patients had H-V times of 55 msec or greater, indicating trifasicular damage. Of these, five had electrocardiographic bifascicular block (RBBB with LAH) with or without additional 1 degrees A-V block. The remaining five patients' electrocardiograms did not suggest trifascicular damage. Since postsurgical trifascicular damage may progress to late onset CHB, conduction studies are indicated to identify patients at risk, despite surface electrocardiographic findings.
S M Yabek; J M Jarmakani; N K Roberts
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  55     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1977 Jan 
Date Detail:
Created Date:  1977-01-29     Completed Date:  1977-01-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  23-7     Citation Subset:  AIM; IM    
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MeSH Terms
Bundle of His / physiopathology
Bundle-Branch Block / diagnosis,  etiology
Child, Preschool
Heart Block / diagnosis,  etiology
Heart Septal Defects, Ventricular / surgery*
Postoperative Complications / diagnosis*
Tetralogy of Fallot / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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