Diagnosis of right ventricular overload by body surface QRST isointegral maps in children with postoperative right bundle branch block

Asano, Yuh; Izumida, Naomi; Kiyohara, Koji; Hosaki, Junro; Kawano, Seiko; Sawanobori, Tohru; Hiraoka, Masayasu

doi:10.1016/s0022-0736(05)80259-6

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…In this study, we examined QRST-I maps in children with ASD to determine whether the abnormalities were caused by primary or secondary T wave change, 19,20 because the QRST-I map could detect hemodynamic RV overload even in the presence of postoperative complete right bundle branch block. 22 The two-maximum pattern of the T map changed to the one-dipole pattern with disappearance of the two-maximum pattern on the QRST-I map despite persistent abnormal depolarization after cardiac repair. This result suggests that an abnormal T wave on the precordial leads in ASD mainly reflects a primary repolarization change, not a secondary change due to RV conduction delay.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, the position of the RV wall near the anterior chest is not a likely cause of the isolated negative T wave. In this study, we examined QRST‐I maps in children with ASD to determine whether the abnormalities were caused by primary or secondary T wave change, 19,20 because the QRST‐I map could detect hemodynamic RV overload even in the presence of postoperative complete right bundle branch block 22 . The two‐maximum pattern of the T map changed to the one‐dipole pattern with disappearance of the two‐maximum pattern on the QRST‐I map despite persistent abnormal depolarization after cardiac repair.…”

Section: Discussionmentioning

confidence: 99%

“…We previously showed characteristic findings on QRST isointegral maps (QRST‐I maps), depending on the type of RV overload in children with congenital heart diseases 21 . The presence of residual RV overload also could be detected using QRST‐I maps in postoperative patients with right bundle branch block complications 22 …”

Section: Introductionmentioning

confidence: 99%

“…21 The presence of residual RV overload also could be detected using QRST-I maps in postoperative patients with right bundle branch block complications. 22 In this study, we examined BSMs of children with ASD before and after intracardiac repair and evaluated the resolution of depolarization and repolarization abnormalities after reduction of RV volume overload.…”

Section: Introductionmentioning

confidence: 99%

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Resolution of Abnormal Body Surface Maps in Children with Atrial Septal Defect after Intracardiac Repair

Asano

Izumida

Kawano³

et al. 2004

Cardiovasc electrophysiol

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Introduction: The genesis of repolarization abnormalities of ECG waveforms in atrial septal defect (ASD), which typically is characterized by right ventricular (RV) volume overload, has not been explored, particularly in association with postoperative hemodynamic improvement. The aim of this study was to evaluate the effects of reduced RV overload after ASD closure on depolarization and repolarization abnormalities on body surface maps (BSMs). Methods and Results: BSMs of 14 children with ASD were recorded preoperatively and at early postoperative (1–6 months) and late postoperative (>9 months) stages. BSMs of 31 age‐matched healthy children were studied as normal controls. Before intracardiac repair, QRS isopotential maps of children with ASD showed delayed RV breakthrough and subsequent rightward enlargement of the positive area with a maximum shifting to the right. Delayed conduction of the RV, particularly at the outflow tract area, was noted. The preoperative QRST isointegral maps exhibited the two‐maximum pattern reflecting repolarization abnormality. The delayed appearance of breakthrough and delayed RV conduction on the QRS isopotential maps persisted from the preoperative to the late postoperative stage, whereas the two‐maximum pattern on the QRST isointegral maps normalized to the one‐dipole pattern at an early stage after repair. Conclusion: Abnormal repolarization parameters in ASD patients showed rapid improvement postoperatively, despite the persistence of depolarization abnormalities. Therefore, the two‐maximum pattern on the QRST isointegral maps indicates a primary T wave change due to hemodynamic RV volume overload.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Resolution of Abnormal Body Surface Maps in Children with Atrial Septal Defect after Intracardiac Repair

Asano

Izumida

Kawano³

et al. 2004

Cardiovasc electrophysiol

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“…Although it is important to know how these factors may affect used IIM characteristics, isointegral mapping of controls in different age and sex groups is very rare (8,9,10,11). Only a very little is known about IIM parameters in children (1,3,4,5,6,8,9). In our study we tried to fill in this gap with amplitude analysis of IIMs of initial parts of the QRS complex in children and young adults.…”

Section: Introductionmentioning

confidence: 99%

Age and Sex Variability of Initial Parts of the QRS Complex Displayed in Isointegral Maps of Young People

Kozlíková

Martinka²

2004

Acta Med. (Hradec Kralove, Czech Repub.)

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Although body surface electrocardiographic mapping is used also in clinical practice, there are only a few papers concerning the isointegral maps (IIMs) in children. We constructed IIMs of 169 healthy young people during the initial parts of the QRS complex: the first 20 ms (QRS20), 30 ms (QRS30), 40 ms (QRS40), and from 20 ms to 40 ms (QRS20–40). Subjects were divided into 6 groups: 9–10 y (F1, M1), 13–14 y (F2, M2), 18–19 y (F3; M3). We analysed the extreme values of each time integral. We found maxima and peak-to-peak values decreasing with age, while minima tended to increase (became less negative). Most age differences were found in IIM QRS20–40 and between peak-to-peak values. Least differences were between minima. Maxima and peak-to-peak values were higher in males than in females. No significant differences were found in any extreme value between groups F1 and M1 except for IIM QRS20 maxima. Significant sex differences increased with age. The only significant difference found in minima was between F2 and M2. Most sex differences were found in IIM QRS20. We assume that our findings can be explained (at least in part) by the influence of heart – chest geometry.

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Elektrokardiographie

Schumacher¹

Klinische Kinderkardiologie

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Diagnosis of right ventricular overload by body surface QRST isointegral maps in children with postoperative right bundle branch block

Cited by 6 publications

References 25 publications

Resolution of Abnormal Body Surface Maps in Children with Atrial Septal Defect after Intracardiac Repair

Resolution of Abnormal Body Surface Maps in Children with Atrial Septal Defect after Intracardiac Repair

Age and Sex Variability of Initial Parts of the QRS Complex Displayed in Isointegral Maps of Young People

Elektrokardiographie

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