QTc and QTd Changes after Cardiopulmonary Bypass Surgery in Children

ORIGINAL RESEARCH, February 2014, VOL III ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.110 , Cite or Link Using DOI
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Aburawi E H, Souid A-k, Liuba P, Pesonen E

ABSTRACT

Objectives:
The aim of the study was to assess the impact of cardiopulmonary bypass surgery on corrected QT (QTc) and QT dispersion (QTd) intervals. The possible role of inflammation on these variables was investigated.

Background: Systemic inflammation and altered myocardial repolarisation are common consequences of cardiopulmonary bypass surgery.

Methods: ECGs were registered and C-reactive protein (CRP) as well as white blood cell (WBC) count were measured in 36 children with ventricular septal defect (VSD) or atrial septal defect (ASD) one day before and 5 days after surgery. QTc and QTd were calculated.

Results: QTc increased after surgery in 24 (67%) patients (mean ± SD = 31 ± 25 ms, range = 7 to 125); whereas QTc decrease was noted in 8 (22%) patients (28 ± 28 ms, range = 1 to 77). After surgery, QTc was abnormally prolonged in 8 (22%) patients (461 ± 18 ms, range = 445 to 487) with normal QT times before surgery. Only one of these 8 patients had abnormally prolonged QTc before surgery. Abnormally prolonged QTc returned to normal in 3 of the 4 patients with prolonged QTc. A trend for increased QTd was also noted. The changes did not correlate with CRP, WBC count, bypass time or aortic cross-clamp time.

Conclusions: Impaired myocardial repolarisation (abnormally prolonged QTc) appeared after surgery in 22% of pediatric patients. The natural history and clinical significance of these alternations, however, deserve further studies. Prolongation of QTc may predispose patients to post-operative arrhythmias