THE INFLUENCE OF THE PERCUTANEOUS PULMONARY VALVE IMPLANTATION ON SELECTED ELECTROCARDIOGRAPHIC PARAMETERS IN PATIENTS WITH CONGENITAL PULMONARY VALVE DEFECT – 12-MONTH FOLLOW-UP
Percutaneous Pulmonary Valve Implantation (PPVI) in patients (pts) with congenital pulmonary valve defect improves hemodynamic parameters. That arises a question whether the procedure influences the electrocardiographic characteristics of the right heart.
Methods: The study comprised 29 pts (16 males), aged 24±7 yrs, with congenital pulmonary valve defect (predominant stenosis – 17pts), (predominant regurgitation – 12 pts), who underwent PPVI. Twelve-lead ECG was performed before and 1 year after PPVI, in which the following variables were analysed: (1) P pulmonale characteristics: P wave amplitude in II, III, avF; (2) right ventricle hypertrophy characteristics: R wave amplitude in V1 and aVR, Sokolow-Lyon index (mV) separately in (R V1+ S V5) and (R V1 + S V6); (3) QRS complex duration (ms) in V1; (4) presence of right bundle branch block (RBBB). Patients with non-sinus rhythm and artificial cardiac pacemakers were excluded from the study.
Results: There was a statistically significant change in the following parameters: (1) reduction in R wave amplitude in V1 and aVR (1.35±1.27 v 1.01±1.05; p=0.01and 0.43±0.35 v 0.34±0.30; p=0.015; (2) reduction in the Sokolow-Lyon index (R V1+ S V5) and (RV1+S V6) (1.98±1.42 v 1.47±1.20; p=0.001 and 1.81±1.48 v 1.32±1.18; p=0.007).
The right ventricle overload and hypertrophy characteristics diminished in 2 out of 16 pts. ‘Pulmonary atrium’ was observed in 4 pts and did not change after PPVI (the respective amplitude of P wave in II, III, avF was 0.18±0.20 v 0.13±0.08, p=0.1; 0.07±0.05 v 0.07±0.04, p=0.12; 0.09±0.06 v 0.09±0.06, p=0.44). The duration of QRS did not change significantly (153.17±46.73 v 156.28±46.4; p=0.19). RBBB diminished in 2 out of 16 pts, no new RBBB was observed after the procedure.
Conclusion: In patients with congenital pulmonary valve diseases right ventricle overload and hypertrophy ECG indicators are observed to decrease 12 months after PPVI.