Wei Li, Lu Yong-Yi, Hua Yi-Min, Zhou Kai-Yu, Ye Qiang-Hua, Wang Chuan, Wang Xiao, Yan Song, Liu Ju-Fang
Department of Pediatrics, West China Second University Hospital/Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu 610041, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Jun;19(6):663-667. doi: 10.7499/j.issn.1008-8830.2017.06.010.
To observe the changes in electrocardiographic parameters in children with complete left bundle branch block (CLBBB) after the transcatheter closure of simple ventricular septal defect (VSD).
A total of 21 children with CLBBB early after transcatheter closure of perimembranous VSD were recruited. Another 21 children without any type of arrhythmia after transcatheter closure of perimembranous VSD were enrolled as the control group. The sex, age, and the size of occluder were matched between the two groups. The changes in the following indices were compared between the two groups: left ventricular voltage, QT interval, corrected QT interval (QTc), QT dispersion (QTd), corrected QT dispersion (QTcd), JT dispersion (JTd), and corrected JT dispersion (JTcd) on the electrocardiogram before transcatheter closure and at 1, 3, 5, 30 days after transcatheter closure.
Left ventricular voltage and JTcd changed with operation time in the CLBBB and control groups (P<0.05). There were interaction effects between time and grouping in the changes in left ventricular voltage and QTd (P<0.05). There was a significant difference in JTcd between the CLBBB and control groups (P<0.05). There was also a significant difference in left ventricular voltage between the CLBBB and control groups at 3 and 5 days after the transcatheter closure (P<0.05).
There are significant differences in electrocardiographic left ventricular voltage and JTcd between VSD children with and without CLBBB early after transcatheter closure. JTcd might be useful in predicting the development of CLBBB early after transcatheter closure of VSD.
观察单纯性室间隔缺损（VSD）经导管封堵术后儿童完全性左束支传导阻滞（CLBBB）心电图参数的变化。
选取21例经导管封堵膜周部VSD术后早期出现CLBBB的儿童。另选取21例经导管封堵膜周部VSD术后无任何类型心律失常的儿童作为对照组。两组在性别、年龄和封堵器大小方面进行匹配。比较两组在经导管封堵术前及术后1天、3天、5天、30天心电图上左心室电压、QT间期、校正QT间期（QTc）、QT离散度（QTd）、校正QT离散度（QTcd）、JT离散度（JTd）和校正JT离散度（JTcd）等指标的变化。
CLBBB组和对照组的左心室电压和JTcd随手术时间变化（P<0.05）。左心室电压和QTd的变化在时间和分组之间存在交互作用（P<0.05）。CLBBB组和对照组之间的JTcd存在显著差异（P<0.05）。经导管封堵术后3天和5天，CLBBB组和对照组之间的左心室电压也存在显著差异（P<0.05）。
经导管封堵术后早期，有CLBBB和无CLBBB的VSD儿童在心电图左心室电压和JTcd方面存在显著差异。JTcd可能有助于预测VSD经导管封堵术后早期CLBBB的发生。
