Comparison of P-Wave Duration and Dispersion in Mitral Valve Replacement Surgery Via Right Atrial Transseptal or Left Atrial Approach in Rheumatic Mitral Stenosis Patients.
Adult
Atrial Appendage
/ surgery
Atrial Septum
/ surgery
Electrocardiography
Female
Follow-Up Studies
Heart Rate
/ physiology
Heart Valve Prosthesis Implantation
/ methods
Humans
Male
Mitral Valve
/ surgery
Mitral Valve Stenosis
/ etiology
Retrospective Studies
Rheumatic Heart Disease
/ complications
Treatment Outcome
Arrhythmias
cardiac
mitral valve stenosis
heart valve prosthesis
electrocardiography
Journal
The heart surgery forum
ISSN: 1522-6662
Titre abrégé: Heart Surg Forum
Pays: United States
ID NLM: 100891112
Informations de publication
Date de publication:
11 03 2020
11 03 2020
Historique:
received:
17
07
2019
accepted:
01
10
2019
entrez:
5
5
2020
pubmed:
5
5
2020
medline:
5
1
2021
Statut:
epublish
Résumé
Predisposition to atrial fibrillation in mitral valve surgery has been well demonstrated. The changes in electrocardiographic parameters (Pmax, Pmin and P-wave dispersion) related to AF risk are unknown. We aimed to document the relationship between electrocardiographic changes and mitral valve replacement through right or left atrial surgical approaches. We retrospectively studied 154 patients, who underwent mitral valve replacement surgery from 2008 to 2018. Seventy-nine patients were operated with right atriotomy and transseptal approach (Group 1), and 75 patents were operated with left atriotomy (Group 2). ECGs obtained at hospital admittance and postoperatively at 24 hours were blindly analyzed. Preoperative demographic characteristics were similar. Pmax, Pmin and P-wave dispersion were similar preoperatively. All parameters increased in both groups compared with the preoperative values (P < .05). Postoperative Pmax, Pmin and P-wave dispersion all were statistically significantly higher with the right atrial approach (P < .05). Postoperative AF also was more common in Group 1 (P < .05). Right atrial approach may lead to higher P-wave changes and atrial arrhythmias. This may be due to more extensive surgical disruption. The changes in atrial anatomic structure can increase atrial arrhythmic propensity and can cause atrial fibrillation.
Sections du résumé
BACKGROUND
Predisposition to atrial fibrillation in mitral valve surgery has been well demonstrated. The changes in electrocardiographic parameters (Pmax, Pmin and P-wave dispersion) related to AF risk are unknown. We aimed to document the relationship between electrocardiographic changes and mitral valve replacement through right or left atrial surgical approaches.
METHODS
We retrospectively studied 154 patients, who underwent mitral valve replacement surgery from 2008 to 2018. Seventy-nine patients were operated with right atriotomy and transseptal approach (Group 1), and 75 patents were operated with left atriotomy (Group 2). ECGs obtained at hospital admittance and postoperatively at 24 hours were blindly analyzed.
RESULTS
Preoperative demographic characteristics were similar. Pmax, Pmin and P-wave dispersion were similar preoperatively. All parameters increased in both groups compared with the preoperative values (P < .05). Postoperative Pmax, Pmin and P-wave dispersion all were statistically significantly higher with the right atrial approach (P < .05). Postoperative AF also was more common in Group 1 (P < .05).
CONCLUSION
Right atrial approach may lead to higher P-wave changes and atrial arrhythmias. This may be due to more extensive surgical disruption. The changes in atrial anatomic structure can increase atrial arrhythmic propensity and can cause atrial fibrillation.
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E118-E122Informations de copyright
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