| T wave alternans threshold late after repair of tetralogy of Fallot. | |
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MedLine Citation:
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PMID: 12139287 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Sustained microvolt-level T wave alternans (TWA) is a marker of increased risk for malignant ventricular arrhythmia. There is a significant risk of arrhythmia and sudden death after repair of congenital heart disease. The aim of this study was to determine the prevalence and characteristics of TWA after repair of tetralogy of Fallot (TOF). METHODS AND RESULTS: TWA was evaluated during bicycle exercise in 49 subjects who had consecutively undergone transatrial-transpulmonary repair. Median values for age, age at repair, and follow-up duration were 14.9 years (11.5-20.8), 1.6 years (0.2-4.9), and 11.6 years (9.4-17.2), respectively. All patients were in New York Heart Association functional class I and were asymptomatic. Median QRS duration was 120 msec (80-150). Sustained TWA was detected in 7 (23%) of 31 subjects with adequate tests. In these 7 subjects, median onset heart rate (HR) was 120 (98-155). Median HR threshold as a percentage of predicted maximum HR (220 - age) was 58% (48-77). Sustained TWA prevalence was not significantly different compared with normal subjects (7/31 vs 9/83; P = 0.1). Onset HR in the TOF group was significantly lower [mean (SD) of 122 (20) vs 139 (12), P < 0.05]. In the TOF group with sustained TWA, the TWA occurred in 4 of 7 at <60% predicted maximum HR versus 1 of 9 normal subjects (P < 0.05); 3 of 7 had onset HR <120 versus 0 of 9 normal subjects (P < 0.03). There was no significant difference in age, gender, transannular patch use, restrictive right ventricular physiology, QRS duration, QTc, QT/QRS dispersion, or nonsustained ventricular tachycardia in subjects with or those without sustained TWA. CONCLUSION: The onset HR for sustained TWA is significantly lower after repair of TOF. Further study is required to determine whether this represents an increased risk for arrhythmia in this patient group. |
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Authors:
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Michael M H Cheung; Robert G Weintraub; Richard J Cohen; Tom R Karl; James L Wilkinson; Andrew M Davis |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 13 ISSN: 1045-3873 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-25 Completed Date: 2003-02-11 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 657-61 Citation Subset: IM; S |
Affiliation:
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Department of Cardiology, Royal Children's Hospital, Melbourne, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cohort Studies Electrocardiography* Female Heart Rate / physiology Humans Male Tachycardia, Ventricular / etiology Tetralogy of Fallot / complications, physiopathology*, surgery* Time Factors |
| Investigator | |
Investigator/Affiliation:
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R J Cohen / MIT, Cambridge |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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