QRST isointegral map reflects the sudden reduction of right ventricular pressure after balloon pulmonary valvuloplasty

Izumida, Naomi; Asano, Yuh; Kiyohara, Koji; Doi, Satomi; Hatai, Yoshiho; Tsuchiya, Shirou; Hosaki, Junro; Kawano, Seiko; Sawanobori, Tohru; Hiraoka, Masayasu

doi:10.1016/s0022-0736(05)80260-2

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Different maps of QRST time‐integral values preoperatively and postoperatively are supposed to disclose the area overlying the ventricle with abnormal repolarization due to volume overload. In our previous report, the areas with changed QRST time‐integral values after sudden RV pressure reduction in patients with pulmonary stenosis were noted near the center of the mid‐anterior chest, 24 whereas the areas in patients with ASD were in the upper part of the mid‐anterior chest and lower part of the left anterior chest. The type of RV overload in ASD and pulmonary stenosis may explain the difference in the location of an affected area.…”

Section: Discussionmentioning

confidence: 80%

“…Changes in myocardial pressure or volume overload affect the electrical properties of ventricular muscles through mechanoelectric transduction, which influences the ST‐T segment and QT interval of the body surface ECG 23 . We previously reported an immediate change on the QRST‐I map with RV pressure reduction following balloon angioplasty in children with pulmonary stenosis 24 . Levine et al 25 described the immediate prolongation of QT interval and action potential duration at a focal endocardial area after RV pressure overload reduction.…”

Section: Discussionmentioning

confidence: 99%

“…23 We previously reported an immediate change on the QRST-I map with RV pressure reduction following balloon angioplasty in children with pulmonary stenosis. 24 Levine et al 25 described the immediate prolongation of QT interval and action potential duration at a focal endocardial area after RV pressure overload reduction. Chen et al 26 also reported that RV overload reduction after cardiopulmonary bypass in patients with RV hypertrophy had little effect on depolarization patterns but had a significant and immediate effect on the epicardial action potential duration.…”

Section: Discussionmentioning

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: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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Precordial leads QRST time integrals for evaluation of right ventricular overload in children with congenital heart diseases

Izumida

Asano

Kiyohara

et al. 1997

Journal of Electrocardiology

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QRST isointegral map reflects the sudden reduction of right ventricular pressure after balloon pulmonary valvuloplasty

Cited by 5 publications

References 17 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

Precordial leads QRST time integrals for evaluation of right ventricular overload in children with congenital heart diseases

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