ISSN: 1223-1533

< Return to the list of articles

THE INFLUENCE OF THE PERCUTANEOUS PULMONARY VALVE IMPLANTATION ON SELECTED ELECTROCARDIOGRAPHIC PARAMETERS IN PATIENTS WITH CONGENITAL PULMONARY VALVE DEFECT – 12-MONTH FOLLOW-UP


Authors: Magdalena Mazgaj, Ewa Piotrowicz, Aneta Fronczak, Katarzyna Elzbieta Biernacka, Marcin Demkow, Witold Ruzyllo, Piotr Hoffman, Ryszard Piotrowicz




 

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.