Abstract:

Objective    To observe the changes of left ventricular voltage，QT interval and QT interval dispersion before and after transcatheter closure for simple ventricular septal defect. Methods     The ECG RV5 （V5 lead r waves），SV1 （V1-lead s-wave），（RV5+SV1） voltage，QT interval and corrected QT interval，QT dispersion （QTd） and heart rate corrected QT dispersion （QTcd） were analyzed in 90 VSD children without arhythmia before transcatheter closure or 1，3，5 days and 1 month after it. All the patients were admitted between January 2014 and January 2015 in Department of Pediatrics West China Second University Hospital of Sichuan University. Results    Left ventricular voltage after transcatheter closure for ventricular septal defect （RV5+SV1） decreased，being with statistical significance on the third day after operation when compared with the preoperative one （P＜0.05）；there were significant differences in QTc before and on the fifth day after operation （P＜0.05）. QTd and QTcd one month after surgery，compared with preoperative and postoperative day，had statistically significant  difference （P ＜ 0.05）. Precordial leads RV5，SV1 voltage and QT interval in the preoperative，postoperative 1，3，5 days，1 month，had no statistically significant difference（P＞0.05）. Conclusion    Cardiac arrhythmia doesn’t occur in simple ventricular septal defect in children after transcatheter closure，and left ventricular voltage will be gradually reduced；corrected QT interval，QTd and QTcd will be shortened.

Key words: ventricular septal defects, heart septal occluder device, left ventricular voltage, QT interval, QT dispersion degree

摘要：

目的    观察单纯室间隔缺损（VSD）患儿介入封堵缺损前后心电图左室电压和QT间期、QT离散度（QTd）的变化。方法    以2014年1月至2015年1月到四川大学华西第二医院儿科心脏介入治疗中心接受以对称型VSD封堵器介入封堵的VSD患儿作为研究对象，收集患儿心电图资料，对90例接受经皮VSD封堵术且手术前后均未发生心律失常患儿的术前、术后1、3、5 d及1个月心电图的RV5 （V5导联R波）、SV1（V1导联S波）、（RV5+SV1）电压和QT间期、心率校正的QT间期（QTc）、QTd及心率校正的QT离散度（QTcd）进行分析。结果    VSD封堵后左室电压（RV5+SV1）降低，且在术后第3天后均与术前差异有统计学意义（P＜0.05）；QTc在术后第5天之后与术前差异有统计学意义（P＜0.05）；QTd和QTcd在术后1个月与术前、术后1 d比较差异有统计学意义（P＜0.05）。胸导联RV5、 SV1电压及QT间期在术前、 术后1、 3、 5 d和1个月的比较差异无统计学意义（P＞0.05）。结论    接受经皮VSD封堵术且手术前后均未发生心律失常的患儿术后左室电压会逐渐降低，QTc、QTd和QTcd会有缩短。

关键词: 室间隔缺损, 心间隔封堵装置, 左心室电压, QT间期, QT离散度