Relations between surgical variables, pulmonary regurgitation, right ventricular function, autonomic heart rate control and QRS duration in adolescents with repaired tetralogy of Fallot

Abstract

Abstract and Keywords Background: Patients with repaired Tetralogy of Fallot have increased risk of arrhythmias, correlating with prolongation of the QRS complex. The underlying mechanisms are uncertain. We explored the relations between different surgical variables, pulmonary regurgitation, right ventricular function, autonomic heart rate control and QRS-duration in adolescents with repaired Tetralogy of Fallot.

Methods and Results: 17 patients (13-18 years) with repaired Tetralogy of Fallot underwent clinical examination, electrocardiogram, echocardiography, exercise testing, testing of autonomic heart rate control and cardiac magnetic resonance imaging. Details of previous surgical procedures were obtained from patients records. All variables were subjected to multivariate linear regression analyses. Patients operated with a transannular patch had larger pulmonary regurgitation fraction (r=18.82 (1.18;36.46), p=0.038). Pulmonary regurgitation was associated with increased right ventricular end diastolic volume (r=1.37 (0.86;1.88), p<0.000), which in turn was related to longer QRS-duration (r=0.40 (0.11;0.70), p=0.011). No other significant interrelations were found.

Conclusion: The use of a transannular patch was the only surgical variable associated with pulmonary regurgitation in our study, in turn leading to right ventricular dilatation and prolongation of the QRS complex.